Propensity Score Analysis in the Comparison of Long-Term Outcomes for Locally Advanced Colon Cancer Between Laparoscopic Colectomy and Open Colectomy

Abstract

Objective: It is difficult to conduct a randomised control trial in a single institution because of the small number of cases. The current study was conducted to investigate if there is any difference in long-term outcome between laparoscopic surgery (LAC) and open surgery (OC) using propensity-score matching analysis based on prognostic factors. Materials:Two hundred and sixteen patients with locally-advanced colon cancer who underwent surgery with curative intent at our department between 2002 and 2010 were enrolled in the current study. Methods:Propensity score matching analysis and Inverse Probability Weighting (IPW) estimator were used to adjust for differences in the clinicopathological severity between LAC and OC.Results: Before propensity score matching analysis recurrence-free survival in LAC was statistically better than that in OC (Hazard ratio = 0.59, 95% CI 0.35-0.98, p = 0.04), and no statistically significant difference was recognized for cancer-specific survival (Hazard ratio = 0.63, 95% CI 0.27-1.37, p = 0.25). After propensity score matching analysis there were no statistically significant differences for recurrence-free (Hazard ratio = 0.91, 95% CI 0.41-2.01, p = 0.81) or cancer-specific survival (Hazard ratio = 1.38, 95% CI 0.41-4.82, p = 0.59). In addition, the IPW estimator revealed that the difference for recurrence-free survival was not significant between the two groups. Conclusion:The one-to-one pair propensity score matching successfully balanced the clinicopathological factors between LAC and OC. The propensity score matching analysis demonstrated no significant difference between LAC and OC.

Surgery, Perioperative Treatment and Prognostic Factors Based on Genetic and Epigenetic Alterations in Colorectal Cancer

“…Up to 2014, we had performed LAC in 1,104 cases of CRC. Long-term outcomes of LAC were compared with those of OC using propensity score (PS)matching of cases because of the major differences in indications for the two procedures 13) . After PS matching, univariate analysis showed no significant differences in clinicopathological factors between LAC and OC cases.…”