Oncological outcomes of laparoscopic versus open surgery in pT4 colon cancers: A systematic review and meta-analysis

Liu, Zhenhua; Wang, Ning; Wang, Feiqing; Dong, Qi; Ding, Jie

doi:10.1016/j.ijsu.2018.06.032

Cited by 37 publications

(36 citation statements)

References 35 publications

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“…The conversion rate in previous studies was approximately 10.7% (range 7.1–28.2%) 17 , and in the current study, 10 patients (7.8%) required open conversion. Among these patients, except in four patients who underwent palliative surgery, R0 and R1 resections were achieved in 5 and 1 patients, respectively.…”

Section: Discussionsupporting

confidence: 52%

Applicability of minimally invasive surgery for clinically T4 colorectal cancer

Liao

Liang

2020

Sci Rep

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The role of minimally invasive surgery (MIS) to treat clinically T4 (cT4) colorectal cancer (CRC) remains uncertain and deserves further investigation. A retrospective cohort study was conducted between September 2006 and March 2019 recruiting patients diagnosed as cT4 CRC and undergoing MIS at a university hospital and its branch. Patients’ demography, clinicopathology, surgical and oncological outcomes, and radicality were analyzed. A total of 128 patients were recruited with an average follow-up period of 33.8 months. The median time to soft diet was 6 days, and the median postoperative hospitalization periods was 11 days. The conversion and complication (Clavien–Dindo classification ≥ II) rates were 7.8% and 27.3%, respectively. The 30-day mortality was 0.78%. R0 resection rate was 92.2% for cT4M0 and 88.6% for pT4M0 patients. For cT4 CRC patients, the disease-free survival and 3-year overall survival were 86.1% and 86.8% for stage II, 54.1% and 57.9% for stage III, and 10.8% and 17.8% for stage IV. With acceptable conversion, complication and mortality rate, MIS may achieve satisfactory R0 resection rate and thus lead to good oncological outcomes for selected patients with cT4 CRC.

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Section: Discussionsupporting

confidence: 52%

Applicability of minimally invasive surgery for clinically T4 colorectal cancer

Liao

Liang

2020

Sci Rep

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“…In a previous study [3] of T4 colon cancer, the conversion rate from laparoscopic to open surgery was reported to be in the range of 7.1-28.2%. Converted patients have high postoperative morbidity and adverse effects on long-term oncologic outcomes [22].…”

Section: Discussionmentioning

confidence: 98%

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

Park

Lee

Park

et al. 2020

Preprint

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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.

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“…In previous studies of T4 colon cancer, the conversion rate from laparoscopic to open surgery was reported to be in the range of 7.1-28.2% [3]. Converted patients have high postoperative morbidity and adverse effects on long-term oncologic outcomes [22].…”

Section: Discussionmentioning

confidence: 99%

Improved Oncologic Outcomes Following Laparoscopic Surgery for Small T4 Colon Cancer : A Multi-center Comparative Study

Lee

Park

et al. 2020

Preprint

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Background: Laparoscopic surgery for T4 colon cancer may be safe in selected patients. Based on the theory that small tumor size might preoperatively predict a good laparoscopic surgery outcome, we herein compare the clinicopathologic and oncologic outcomes of open and laparoscopic 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 cm, who underwent T4 colon cancer surgery between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open surgery groups.Results: Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (86 mL vs. 278 mL, p < 0.001; 10.0 days vs. 12.5 days, p = 0.003; and 18.0% vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in overall survival (OS) and 3-year disease-free survival (DFS; 87.8% vs. 83.2%, p = 0.117; 69.5% vs. 68.1%, p = 0.408, respectively). Among patients with tumors of size ≤4 cm, blood loss was lower in the laparoscopic surgery group than in the open group (80 mL vs. 208 mL, p = 0.001); despite no statistical difference observed in the 3-year OS (84.4% vs 78.7%, p = 0.442), the laparoscopic group had a better 3-year DFS (73.8% vs. 46.0%, p = 0.004).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 small T4 tumors.

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Oncological outcomes of laparoscopic versus open surgery in pT4 colon cancers: A systematic review and meta-analysis

Abstract: Laparoscopic surgery is safe and feasible in pT4 colon cancer, oncological outcomes are similar, and more importantly, there are fewer postoperative complications compared with open surgery.

Cited by 37 publications

References 35 publications

Applicability of minimally invasive surgery for clinically T4 colorectal cancer

Applicability of minimally invasive surgery for clinically T4 colorectal cancer

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

Improved Oncologic Outcomes Following Laparoscopic Surgery for Small T4 Colon Cancer : A Multi-center Comparative Study

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