Background
There has been a growing trend toward minimally invasive surgery (MIS) for colon cancer. Pathological analysis of a minimum of 12 lymph nodes (LNs) is a benchmark for adequate resection. Here, we present a comparison of surgical techniques in achieving a full oncologic resection.
Methods
Patients undergoing surgery for Stage I–III colon cancer (2010–2016) were identified from the National Cancer Database. Cases were stratified by surgical approach. Trends in approach were assessed, including whether the 12‐LN benchmark was met. Uni‐ and multivariate regression was used to assess overall survival (OS).
Results
A total of 290,776 colectomies were analyzed. MIS increased from 32.8% to 57.2% from 2010 to 2016 (p < .001). An overall median of 18 LNs were harvested and compliance with the 12‐LN benchmark increased (84.6%–91.6%, p < .001); there were no difference between open and MIS. A subset analysis comparing hospital type revealed that regardless of approach, compliance was lower at community hospitals (p < .001). OS was better for patients treated at academic or National Cancer Institute centers, underwent MIS, and in those meeting the 12‐LN benchmark (all p ≤ .002).
Conclusion
As MIS colon resections continue to increase, we demonstrate that there is no difference in the ability to achieve the 12‐LN benchmark with open and MIS approaches.
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