Comparison of survival of patients receiving laparoscopic and open radical resection for stage II colon cancer

Abstract

BackgroundThe aim of the study was to compare the survival of patients receiving laparoscopic vs. open radical resection for stage II colon cancer.Patients and methodsTwo hundred and twenty patients with stage II colon cancer were enrolled from Beijing Chaoyang Hospital of Capital Medical University from January 2000 to December 2009, including 61 patients in the laparoscopic radical resection group and 159 patients in the open radical resection group. The survival data in both groups were compared using the log rank test based on Kaplan-Meier survival curves.ResultsThere was no statistically significant difference in the 3-year survival (88.5% vs. 80.5%; X2=1.98, P=0.159) and the 5-year survival (81.9% vs. 69.2%; X2=1.98, P=0.159) between both groups. However, statistically significant difference was found in median overall survival (mOS), which was 102.6 (95% CI: 76.8–122.7) months in the laparoscopic group and 90.0 (95% CI: 70.4–109.6) months in the open radical resection group (X2=4.183, P=0.041). mOS was 96 (95% CI: 68.6–111.4) months and 92.6 (95% CI: 56.8–107.2) months in those with and without postoperative chemotherapy, respectively (X2=6.389, P=0.011). For patients older than 75 years the mOS was 90.0 (95% CI: 25.3–105.0) months and 83.4 (95% CI: 13.1–96.9) months in the laparoscopic and open group, respectively. The difference between the both groups was statistically significant (X2=6.191, P=0.013).ConclusionsThe mOS of patients receiving laparoscopic radical resection was better than open radical resection for stage II colon cancer, especially for patients over 75 years old.

Improved survival with early adjuvant chemotherapy after colonic resection for stage III colonic cancer: A nationwide study

“…There is now broad consensus that the laparoscopic approach is at least comparable to open surgery with respect to quality of resection and survival in colonic cancer . Similar to our findings, it was recently shown that laparoscopic surgery increases the chances of early adjuvant therapy .…”

“…Time to referral to oncological treatment was median (interquartile range [i.q.r.]) 15 (12)(13)(14)(15)(16)(17)(18)(19)(20) days after surgery, time to first visit at the department of oncology was median (i.q.r) 27 (21-33) days, and adjuvant treatment was started a median (i.q.r.) of 2 weeks later-at 41 (34-50) days after surgery.…”

“…If an even earlier start, as within 4 weeks after surgery, can provide further improvements is yet to be established. It is well documented that laparoscopic resection is at least comparable to open resection in terms of major outcome measures such as 30‐day mortality, positive resection margins, recurrence, and long‐term disease‐free and overall survival . In Denmark, more than 60% of patients with colonic cancer are operated by the laparoscopic approach .…”

Robotic versus laparoscopic surgery for colorectal cancer: a case-control study

“…[1][2][3] There is even some evidence that LCR result in better median overall survival for patients with stage II colon cancer, older than 75 years, when compared to open surgery. 4 Robotic surgical systems were designed to overcome the limitations of laparoscopic surgery, offering better visualization with three-dimensional magnified view and stable camera platform, stabilization of tremors and greater dexterity of movements. Moreover, they also improve the ergonom-ics, possibly reducing fatigue of the operating surgeon.…”

“…1 , 2 , 3 There is even some evidence that LCR result in better median overall survival for patients with stage II colon cancer, older than 75 years, when compared to open surgery. 4 …”