900 Transitional impact of short and long-term outcomes of a randomized controlled trial to evaluate laparoscopic versus open surgery for colorectal cancer from Japan Clinical Oncology Group Study JCOG0404

Fujii, Shouichi; Inomata, Masafumi; Akagi, Tomonori; Katayama, Hokahiro; Mizusawa, Junki; Saito, S; Saida, Yoshihisa; Munakata, Yasuhiro; Sato, Takeo; Bandou, Hiroyuki; Sekimoto, M.; Yamamoto, Hirofumi; Shimada, Yasuhiro; Kitano, Seigo

doi:10.1016/s0959-8049(15)30014-9

Cited by 5 publications

(6 citation statements)

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“…With regard to survival, this study found that 5-year survival rates were comparable in the two groups and were similar to those found in other previous reports of conventional laparoscopic rectal surgery [30][31][32][33]. Factors related to 5-year survival included circumferential margin, number (CRM), harvested lymph node, mesorectal grade, and postoperative complications [34].…”

Section: Discussionsupporting

confidence: 86%

Comparison of Survival between Single-Access and Conventional Laparoscopic Surgery in Rectal Cancer

Sirikurnpiboon

2021

Minimally Invasive Surgery

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Introduction. Innovative laparoscopic surgery for rectal cancer can be classified into 2 types: firstly, new instruments such as robotic surgery and secondly, new technique such as single-access laparoscopic surgery (SALS) and transanal total mesorectal excision (TaTME). Most reports of SALS for rectal cancer have shown pathologic outcomes comparable to those of conventional laparoscopic surgery (CLS); however, SALS is considered to be superior to CLS in terms of lower levels of discomfort and faster recovery rates. This study aimed to compare the survival outcomes of the two approaches. Methods. From 2011 to 2014, 84 cases of adenocarcinoma of the rectum and anal canal were enrolled. The operations were anterior, low anterior, intersphincteric, and abdominoperineal resections. Data collected included postoperative outcomes. The oncological outcomes recorded included 3-year and 5-year survival, local recurrence, and metastasis. Results. SALS was performed on 41 patients, and CLS was utilized in 43 cases. The demographic data of the two groups were similar. Intraoperative volumes of blood loss and conversion rates were similar, but operative time was longer in the SALS group. There were no significant differences in postoperative complications or pathological outcomes. The oncologic results were similar in terms of 3-year survival (100% and 97.7%; p = 1.00), 5-year survival (78.0% and 86.0%; p = 0.401), local recurrence rates (19.5% vs 11.6%, p = 0.376), and metastasis rates (19.5% vs 11.6%; p = 0.376) for SALS and CLS, respectively. Conclusion. SALS and CLS for rectal and anal cancer had comparable pathological and survival results, but SALS showed some superior benefits in the early postoperative period.

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Section: Discussionsupporting

confidence: 86%

Comparison of Survival between Single-Access and Conventional Laparoscopic Surgery in Rectal Cancer

Sirikurnpiboon

2021

Minimally Invasive Surgery

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“…Large-scale randomized controlled trials and meta-analyses have indicated that laparoscopic surgery for colon cancer is equivalent or better than open surgery with regard to safety, feasibility, blood loss, postoperative pain, cosmesis, length of hospital stay, and oncological outcomes. [1][2][3][4][5][6][7][8][9][10] Locally advanced colorectal cancers sometimes invade or adhere to adjacent organs. In those cases, it is often difficult to determine whether adhesions between the tumor and the adjacent organs are due to a malignant invasion or a benign inflammatory change; consequently, radical removal requires an en bloc multivisceral resection with a safe margin.…”

Section: Introductionmentioning

confidence: 99%

“…The laparoscopic colectomy can be applied to a wide range of conditions—from early to advanced cancer and from colon cancer to rectal cancer. Large‐scale randomized controlled trials and meta‐analyses have indicated that laparoscopic surgery for colon cancer is equivalent or better than open surgery with regard to safety, feasibility, blood loss, postoperative pain, cosmesis, length of hospital stay, and oncological outcomes 1–10 …”

Section: Introductionmentioning

confidence: 99%

Short‐term and long‐term outcomes of laparoscopic colectomy with multivisceral resection for surgical T4b colon cancer: Comparison with open colectomy

Miyo

Kato

Takahashi

et al. 2020

Annals of Gastroent Surgery

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Aim In response to the rising use of laparoscopic surgery, recent studies have shown that laparoscopic multivisceral resections for locally advanced colon cancer are safe, feasible, and provide acceptable oncological outcomes. However, the usefulness of laparoscopic multivisceral resection remains controversial. Here, we aimed to compare short‐term and long‐term outcomes between laparoscopic and open multivisceral resection approaches for treating locally advanced colon cancer. Methods We retrospectively collected data on 1315 consecutive patients admitted to the National Hospital Organization, Osaka National Hospital, for surgical treatment of colorectal cancer between 2010 and 2017. We assessed invasiveness in terms of operating times, blood loss, and complications. Oncological outcomes included 5‐year survival rates and recurrences. Results We included 85 patients that underwent a colectomy with a multivisceral resection for locally advanced colon cancer; of these, 38 were treated with a laparoscopic approach and 47 were treated with an open approach. Compared to the open surgery group, the laparoscopic group had significantly less blood loss (median volume: 25 vs 140 mL, P <0.001), a lower complication rate (10.5% vs 29.8%, P = 0.036), and shorter hospital stays (12 vs 15 days, P = 0.028). After excluding patients with stage Ⅳ colon cancer, the groups showed similar pathologic outcomes and no significant differences in 5‐year disease‐free survival (73.9% vs 67.4%; P = 0.664) or 5‐year overall survival (75.8% vs 67.7%; P = 0.695). Conclusion A laparoscopic approach for locally advanced colon cancer could be less invasive than an open approach without affecting oncological outcomes in selected patients.

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“…According to a European multicenter randomized trial, patients undergoing open colectomy for stage I-III colon cancer had a mean hospital length of stay (LOS) of 9:3 ± 7:3 days and a postoperative complication rate of 20% in [4]. A Japanese randomized controlled trial found that for the periods of 2004-2005, 2006-2007, and 2008-2009, the mean lengths of hospital stay were 12, 11, and 11 days, respectively, and postoperative complication rates were 27.6%, 20.3%, and 21.3%, respective, in patients with stage II/III colon cancer after open surgery [5]. Furthermore, an analysis of American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) data revealed that in colon cancer patients undergoing open surgery, the postoperative complication rate was 25.3%, the mean hospital LOS was 9:5 ± 6:3 days, and 30-day mortality rate was 2.9% [6].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Comorbid Diabetes on Short-Term Postoperative Outcomes in Stage I/II Colon Cancer Patients Undergoing Open Colectomy

Lee

Chung

Chen

et al. 2020

BioMed Research International

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Purpose. This study aimed at evaluating the impact of comorbid diabetes on short-term postoperative outcomes in patients with stage I/II colon cancer after open colectomy. Methods. The data were extracted from the National Inpatient Sample database (2005-2010). Short-term surgical outcomes included in-hospital mortality, postoperative complications, and hospital length of stay. Results. A total of 49,064 stage I/II colon cancer patients undergoing open surgery were included, with a mean age of 70.35 years. Of them, 21.94% had comorbid diabetes. Multivariable analyses revealed that comorbid diabetes was significantly associated with a lower risk of in-hospital mortality and postoperative complications. Compared to patients without diabetes, patients with uncomplicated diabetes had lower percentages of in-hospital mortality and postoperative complications, but patients with complicated diabetes had a higher percentage of postoperative complications. In addition, patients with diabetes only, but not patients with diabetes and hypertension only, had a lower percentage of in-hospital mortality than patients without any comorbidity. Conclusion. The present results suggested the protective effects of uncomplicated diabetes on short-term surgical outcomes in stage I/II colon cancer patients after open colectomy. Further studies are warranted to confirm these unexpected findings and investigate the possible underlying mechanisms.

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900 Transitional impact of short and long-term outcomes of a randomized controlled trial to evaluate laparoscopic versus open surgery for colorectal cancer from Japan Clinical Oncology Group Study JCOG0404

Cited by 5 publications

References 0 publications

Comparison of Survival between Single-Access and Conventional Laparoscopic Surgery in Rectal Cancer

Comparison of Survival between Single-Access and Conventional Laparoscopic Surgery in Rectal Cancer

Short‐term and long‐term outcomes of laparoscopic colectomy with multivisceral resection for surgical T4b colon cancer: Comparison with open colectomy

The Impact of Comorbid Diabetes on Short-Term Postoperative Outcomes in Stage I/II Colon Cancer Patients Undergoing Open Colectomy

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