Comparison of open and minimally invasive approaches to colon cancer resection in compliance with 12 regional lymph node harvest quality measure

Abstract

Background There has been a growing trend toward minimally invasive surgery (MIS) for colon cancer. Pathological analysis of a minimum of 12 lymph nodes (LNs) is a benchmark for adequate resection. Here, we present a comparison of surgical techniques in achieving a full oncologic resection. Methods Patients undergoing surgery for Stage I–III colon cancer (2010–2016) were identified from the National Cancer Database. Cases were stratified by surgical approach. Trends in approach were assessed, including whether the 12‐LN benchmark was met. Uni‐ and multivariate regression was used to assess overall survival (OS). Results A total of 290,776 colectomies were analyzed. MIS increased from 32.8% to 57.2% from 2010 to 2016 (p < .001). An overall median of 18 LNs were harvested and compliance with the 12‐LN benchmark increased (84.6%–91.6%, p < .001); there were no difference between open and MIS. A subset analysis comparing hospital type revealed that regardless of approach, compliance was lower at community hospitals (p < .001). OS was better for patients treated at academic or National Cancer Institute centers, underwent MIS, and in those meeting the 12‐LN benchmark (all p ≤ .002). Conclusion As MIS colon resections continue to increase, we demonstrate that there is no difference in the ability to achieve the 12‐LN benchmark with open and MIS approaches.

Short term results in a population based study indicate advantage for laparoscopic colon cancer surgery versus open

“…R1 resection is a wellknown negative prognostic factor affecting long-term survival and follow-up is required to evaluate if the increase www.nature.com/scientificreports/ in positive margins seen in this study will lead to long term survival benefits following LAP compared to OPEN as indicated in few population based studies 19,37 . Our unweighted analysis found similarly to previous registry studies no difference in the proportion of resections with 12 or more lymph node yield 5,18 . The significantly higher rate of resections with sufficient number of lymph nodes indicated in the weighted regression analysis has not been reported elsewhere.…”

“…Despite the encouraging results, the implementation of laparoscopic surgery for colon cancer in Sweden has been slow compared to other laparoscopic procedures, as in many other countries [16][17][18] . However, since 2010, there has been a steady increase in the use of laparoscopic technique for elective colon cancer in Sweden, surpassing 50% in 2017, still many surgeons perform open resections 19,20 .…”

Value of MSCT plus MRI in the Detection of Colon Cancer

“…Currently, the common diagnostic methods for colon cancer patients include ultrasound diagnosis, CT, and MRI. MSCT has been widely applied due to its strengths in observing the location of the lesion [ 7 – 9 ]. MRI diagnosis emerges with the development of medical technology and also receives widespread attention.…”

Colorectal Cancer in a 17-Year-Old Boy: A Case Report

“…18 Late diagnosing and treating colon cancer are potentially associated with the worst prognosis. 19 Colon cancer cases in adolescents are often diagnosed late because of their rare prevalence. 6,21,22 Based on this, it is necessary to pay attention to the symptoms of colon cancer in adolescents, proper physical examination, and available diagnostic testing facilities so that colon cancer in adolescents can be detected and treated immediately.…”