Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial

Kitano, Seigo; Ito, Masafumi; Mizusawa, Junki; Katayama, Hiroshi; Watanabe, Masahiko; Yamamoto, Seiichiro; Ito, Masaaki; Saito, Shuji; Fujii, Satoshi; Konishi, Fumio; Saida, Yoshihisa; Hasegawa, Hirotoshi; Akagi, Tomonori; Sugihara, Kenichi; Yamaguchi, Takashi; Terabe, Masaki; Fukunaga, Yosuke; Murata, Kohei; Okajima, Masazumi; Moriya, Yoshihiro; Shimada, Yasuhiro

doi:10.1016/s2468-1253(16)30207-2

Cited by 240 publications

(220 citation statements)

References 26 publications

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“…Furthermore, no clear disadvantages in terms of postoperative oncological outcomes have been shown in cases of colon cancer (6)(7)(8)(9)(10)(11)(12)(13). Compared with OS, this approach has been reported to be associated with better shortterm outcomes, including earlier recovery, shorter hospital stay, and a lower rate of mechanical small bowel obstruction or ileus.…”

Section: Discussionmentioning

confidence: 99%

“…Multiport laparoscopic surgery (MPLS) for colorectal surgery is widely accepted as conventional laparoscopic surgery because of its reduced invasiveness, good shortterm and oncological outcomes, good cosmetic outcomes, and reduced cost burden (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). Recently, to further reduce surgical invasiveness and improve cosmetic outcomes, surgeons proficient in conventional laparoscopic and endoscopic surgeries developed SILS techniques and NOTES.…”

Section: Introductionmentioning

confidence: 99%

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Short‐term and midterm outcomes of single‐incision laparoscopic surgery for right‐sided colon cancer

Ishii

Yahagi

Ochiai

et al. 2018

Asian J Endoscop Surgery

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Introduction: The purpose of this study was to clarify the usefulness of SILS for right-sided colon cancer by evaluating the short-term and midterm outcomes.Methods: Between 2012 and 2017, 65 selected patients with right-sided colon cancer underwent ileocecal resection, right hemicolectomy, or transverse colectomy; all were enrolled in the study. The same well-trained surgeon performed each procedure by using a multi-instrument access port with three channels, which was placed at the umbilicus via an approximately 3-cm skin incision.Results: The pathological disease stage distribution was stage 0, 4 cases; stage I, 23 cases; stage II, 19 cases; stage III, 17 cases; and stage IV, 2 cases. The surgical procedures performed were ileocecal resection, 23 cases; right hemicolectomy, 35 cases; and transverse colectomy, 7 cases. The median operative time and intraoperative blood loss were 216 min and 10 mL, respectively. Although 18 cases needed additional ports, none required conversion to open surgery. The median number of harvested lymph nodes was 24. No major perioperative morbidities occurred in this patient series. The median postoperative hospital stay was 7 days. The median follow-up period was 30 months, and the 3-year relapse-free and overall survival rates were 100% and 100%, respectively, in the stage 0-I cases and 89% and 96% in the stage II-III cases, respectively. Conclusion:We concluded that SILS is as feasible as multiport laparoscopic surgery and a reliable surgical option in selected cases of right-sided colon cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Short‐term and midterm outcomes of single‐incision laparoscopic surgery for right‐sided colon cancer

Ishii

Yahagi

Ochiai

et al. 2018

Asian J Endoscop Surgery

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“…JCOG0404 was registered with the UMIN Clinical Trials Registry, number C000000105, and http://ClinicalTrials.gov, number NCT00147134. The details of the JCOG0404 study have been reported elsewhere …”

Section: Methodsmentioning

confidence: 99%

Clinical impact of D3 lymph node dissection with left colic artery (LCA) preservation compared to D3 without LCA preservation: Exploratory subgroup analysis of data from JCOG0404

Akagi

Ito

Hara

et al. 2020

Annals of Gastroent Surgery

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Aim We investigated the clinical impact of D3 lymph node dissection preserving left colic artery (LCA) compared to D3 without LCA preservation using data from JCOG0404. LCA preservation is expected to maintain adequate blood supply, which is effective in preventing anastomotic leakage, intestinal paralysis, and bowel obstruction. Whether D3 with LCA preservation (Group A) improves clinical outcomes following resection of sigmoid colon cancer compared to D3 without LCA preservation (Group B) is unclear. Methods Procedure type was identified from photographs of the surgical field collected for central surgical review in JCOG0404. Clinical outcomes were compared between each procedure. Results Among the 1057 randomized patients in JCOG0404, 631 patients receiving sigmoid colectomy or anterior resection were included in the subgroup analysis. Group A comprised of 135 patients and Group B of 496 patients. Patient backgrounds did not differ between groups. Median operative time, blood loss, anastomotic leakage, and intestinal paralysis were not remarkably different (Group A vs Group B: 185 vs 186 minutes, 60 vs 50 mL, 3.0% vs 5.0%, and 2.2% vs 3.8%). More overall postoperative complications occurred in Group B than Group A (21.6% vs 9.6%, P = .022). Five‐year relapse‐free survival (RFS) and overall survival (OS) tended to be better in Group A than Group B (RFS: 83.7% and 80.5%, HR 0.80 [95% CI 0.51‐1.26], OS: 96.3% and 91.1%, HR 0.41 [95% CI 0.19‐0.89]). Conclusions Short‐ and long‐term outcomes tend to be better in Group A than Group B, indicating that preservation of LCA could be an alternative treatment.

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“…Furthermore, survival outcomes following laparoscopic versus open D3 dissection were examined. Laparoscopic D3 surgery was inferior to open D3 surgery; laparoscopic D3 surgery could be an acceptable treatment option for patients with stage II or III colon cancer [31]. …”

Section: Forefront Of Colorectal Treatment (Core Symposium 1 At the 1mentioning

confidence: 99%

Interaction between Medical Treatment and Minimally Invasive Surgical Treatment for the Malignancies of the Digestive Tract

et al. 2018

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Recently, endoscopic diagnosis and treatment methods for early cancer in the digestive tract have made rapid progress. As for surgery, laparoscopic and thoracoscopic techniques have achieved rapidly advancing development in the last 2 decades. Early detection of the malignant lesion and the evolution of endoscopic and surgical device enabled in performing the minimally invasive surgery. Collaboration of medical treatment and minimally invasive surgery for advanced cancer is ongoing in the case of some conditions and in a few institutes. In this review, the contents of the core symposia on “Interaction between medical treatment and minimally invasive surgical treatment for the malignancies of the digestive tract", held at the 11, 12 and 13th annual meeting of the Japanese Gastroenterological Association, are summarized. At each annual meeting, the core symposium focused primarily on gastric, colorectal, and esophageal cancer treatment. For gastric cancer, endoscopic resection and laparoscopic surgery were 2 important key words. For colorectal cancer, multidisciplinary therapy was a major key word. And for esophageal cancer, endoscopic resection, chemoradiotherapy, thoracoscopic surgery and salvage surgery were key words. Patients’ survival and quality of life are expected to further advance as a result of the collaboration of such therapeutic modalities.

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Survival outcomes following laparoscopic versus open D3 dissection for stage II or III colon cancer (JCOG0404): a phase 3, randomised controlled trial

Cited by 240 publications

References 26 publications

Short‐term and midterm outcomes of single‐incision laparoscopic surgery for right‐sided colon cancer

Short‐term and midterm outcomes of single‐incision laparoscopic surgery for right‐sided colon cancer

Clinical impact of D3 lymph node dissection with left colic artery (LCA) preservation compared to D3 without LCA preservation: Exploratory subgroup analysis of data from JCOG0404

Interaction between Medical Treatment and Minimally Invasive Surgical Treatment for the Malignancies of the Digestive Tract

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