Favorable short-term oncologic outcomes following laparoscopic surgery for small T4 colon cancer : a multicenter comparative study

Abstract

Background: Laparoscopic surgery for T4 colon cancer may be safe in selected patients. We hypothesized that small tumor size might preoperatively predict a good laparoscopic surgery outcome. Herein we compared the clinicopathologic and oncologic outcomes of laparoscopic and open surgery in small T4 colon cancer. Methods: In a retrospective multicenter study, we reviewed the data of 449 patients, including 117 patients with tumors ≤ 4.0 cm who underwent surgery for T4 colon cancer between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open groups. Survival curves were estimated using the Kaplan–Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards model . A p < 0.05 was considered statistically significant. Results: Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (median [range]: 50 [0–700] vs. 100 [0–4000] mL, p < 0.001; 8 vs. 10 days, p < 0.001; and 18.0 vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in 3-year overall survival or disease-free survival (86.6 vs. 83.2%, p = 0.180 and 71.7 vs. 75.1%, p = 0.720, respectively). Among patients with tumor size ≤4.0 cm, blood loss was significantly lower in the laparoscopic group than in the open group (median [range]: 50 [0–530] vs. 50 [0–1000] mL, p = 0.003). Despite no statistical difference observed in the 3-year overall survival rate (83.3 vs. 78.7%, p = 0.538), the laparoscopic group had a significantly higher 3-year disease-free survival rate (79.2 vs. 53.2%, p = 0.012). Conclusions: Laparoscopic surgery showed similar outcomes to open surgery in T4 colon cancer patients , and may have favorable short-term oncologic outcomes in patients with tumors ≤4.0 cm.

Prognosis of Laparoscopic Surgery for Colorectal Cancer in Middle-Aged Patients: A Propensity Score-Matched Analysis

“…Similar results were reported by Law et al (33). Park et al (34) reported that similar outcomes between LR and OR in T4 tumors, but a tendency for better outcomes with LR in tumors < 4 cm. Hence, contradictory results can be observed in the literature.…”