Laparoscopic versus open resection in patients with locally advanced colon cancer

Huynh, Caroline; Minkova, Stephanie; Kim, Diane; Stuart, Heather; Hamilton, Trevor D.

doi:10.1016/j.surg.2021.07.027

Cited by 15 publications

(9 citation statements)

References 50 publications

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“…The rates for different types of recurrence observed in this study are in line with those reported in the recently published international, multicenter study [8]. Moreover, the association between pathology findings (pT and pN stages) and the development peritoneal carcinomatosis confirms previously published results [8,15,18]. As mentioned, some authors have reported heterogenous cohorts including both open and laparoscopic procedures thereby trying to address the role of surgical approach in recurrence pattern for LACC [11,15,17,23].…”

Section: Discussionsupporting

confidence: 90%

“…In this study, recurrence rate following curative resection for LACC was 52.5%, which is higher than reported in the literature [9,15,16]. At the same time, the proportion of patients that had received adjuvant chemotherapy was only 34.7%.…”

Section: Discussioncontrasting

confidence: 67%

“…At the same time, the proportion of patients that had received adjuvant chemotherapy was only 34.7%. Although adjuvant chemotherapy was not a significant predictor for recurrence in the multivariable analysis, one should pay attention that its application was still significantly low when comparing with the literature data (41.7–72.8%) [ 8 , 9 , 15 , 17 – 19 ]. There can be various reasons to relatively uncommon use of adjuvant chemotherapy in our patients.…”

Section: Discussionmentioning

confidence: 82%

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Recurrence After Colectomy for Locally Advanced Colon Cancer: Experience from a Developing Country

Sahakyan

Aleksanyan

Batikyan

et al. 2022

Indian J Surg Oncol

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Risk factors for disease recurrence following curative resection for locally advanced colon cancer (LACC) remain unclear as conflicting results have been reported in the literature. The aim of this study was to examine these factors in the setting of developing country’s health care system affected by limited accessibility to the multimodal cancer treatment. Patients who had undergone curative colon resection for LACC between 2004 and 2018 were included. Data were obtained from a prospectively maintained database. Factors associated with disease recurrence, types of recurrence and recurrence-free survival were studied. A total of 118 patients with LACC were operated within the study period. Median follow-up was 36 (2-147) months. Adjuvant therapy was used in 41 (34.7%) patients and 62 (52.5%) were diagnosed with recurrence. In the multivariable analysis, disease recurrence was associated with tumor and nodal stages, as well as with the lymph node yield. Local recurrence, distant metastases, and peritoneal carcinomatosis were observed in 8 (6.8%), 30 (25.4%), and 24 (20.3%) patients, respectively. Early recurrence was diagnosed in 27 (22.9%) cases with peritoneal carcinomatosis being its most common type. Preoperative serum CA 19–9 levels, tumor, and nodal stages were linked to recurrence-free survival in the univariable analysis. Only tumor stage remained such in the multivariable model. Our findings suggest that lymph node yield, tumor, and nodal stages are associated with recurrence following curative resection for LACC.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 82%

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Recurrence After Colectomy for Locally Advanced Colon Cancer: Experience from a Developing Country

Sahakyan

Aleksanyan

Batikyan

et al. 2022

Indian J Surg Oncol

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“…At that time, the post-operative mortality and recurrence rate, and the incidence of post-operative complications were very high due to insufficient surgical equipment and inexperienced surgical technique, especially incomplete resection (38)(39)(40)(41). With the development of numerous medical facilities, from laparotomy through laparoscopy to robotic surgery, and the rapid developing of medical science and technology have broken the difficulty of the en bloc resection, greatly increased the possibility of surgery, and lowered the incidence of post-operative complications (42)(43)(44)(45)(46)(47)(48)(49)(50). Currently, when RCC has invaded the duodenum and/or pancreas, this en bloc resection is No.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of locally advanced right colon cancer invading neighboring organs

Kang²,

Zhang³

et al. 2023

Front. Med.

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PurposeInvasion of the pancreas and/or duodenum with/without neighboring organs by locally advanced right colon cancer (LARCC) is a very rare clinical phenomenon that is difficult to manage. The purpose of this review is to suggest the most reasonable surgical approach for primary right colon cancer invading neighboring organs such as the pancreas and/or duodenum.MethodsAn extensive systematic research was conducted in PubMed, Medline, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) using the MeSH terms and keywords. Data were extracted from the patients who underwent en bloc resection and local resection with right hemicolectomy (RHC), the analysis was performed with the survival rate as the outcome parameters.ResultsAs a result of the analysis of 117 patient data with locally advanced colon cancer (LACC) (73 for males, 39 for females) aged 25–85 years old from 11 articles between 2008 and 2021, the survival rate of en bloc resection was 72% with invasion of the duodenum, 71.43% with invasion of the pancreas, 55.56% with simultaneous invasion of the duodenum and pancreas, and 57.9% with invasion of neighboring organs with/without invasion of duodenum and/or pancreas. These survival results were higher than with local resection of the affected organ plus RHC.ConclusionWhen the LARCC has invaded neighboring organs, particularly when duodenum or pancreas are invaded simultaneously or individually, en bloc resection is a reasonable option to increase patient survival after surgery.

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“…A randomized controlled trial comparing open and laparoscopic surgery for colon cancer (JCOG0404) also found no significant differences in the rate of peritoneal recurrence between the two approaches (20). Conversely, a conflicting study showed an association between the laparoscopic approach and increased risk for peritoneal recurrence (21). We believe that it is important to avoid direct contact with the tumor as much as possible during laparoscopic surgery for pT4a, since the cancer cells are exposed on the surface of the serosa and may be disseminated by the surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

Prognostic risk factors for pT4 colon cancer: A retrospective cohort study

et al. 2022

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The present study aimed to clarify the prognostic risk factors for pathological T4 (pT4) colon cancer and provide a basis for improved treatment in affected patients. The current retrospective cohort study included 83 consecutively enrolled patients who underwent curative surgery for primary pT4 colon cancer between January 2014 and December 2021 at Tokyo Medical Women's University (Tokyo, Japan). Oncological outcomes, including recurrence pattern, were compared between patients with pT4a and pT4b colon cancer. Independent risk factors associated with overall survival (OS) and relapse-free survival (RFS) were analyzed using a multivariate Cox regression model. The 3-year OS rates were 85.1 and 95.0% in the pT4a and pT4b groups (P=0.089) and 3-year RFS rates were 64.1 and 60.5% (P=0.589), respectively. Moreover, the 3-year peritoneal recurrence-free survival was 71.0 and 90.2% (P=0.085) in these groups, respectively. Independent risk factors for OS were histology (mucinous or poorly differentiated adenocarcinoma), tumor location (right-sided) and pN status (positive). The risk factors for RFS were histology and pN status. Patients with pT4b colon cancer and R 0 resection may not have a poorer prognosis compared with those with pT4a colon cancer. However, patients with pT4a colon cancer tended to have more peritoneal recurrence patterns. Histology and pN status were associated with OS and RFS, and right-sided colon cancer was also a risk factor for OS.

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Laparoscopic versus open resection in patients with locally advanced colon cancer

Cited by 15 publications

References 50 publications

Recurrence After Colectomy for Locally Advanced Colon Cancer: Experience from a Developing Country

Recurrence After Colectomy for Locally Advanced Colon Cancer: Experience from a Developing Country

Surgical treatment of locally advanced right colon cancer invading neighboring organs

Prognostic risk factors for pT4 colon cancer: A retrospective cohort study

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