Identification of patient subgroups with unfavorable long‐term outcomes associated with laparoscopic surgery in a randomized controlled trial comparing open and laparoscopic surgery for colon cancer (Japan Clinical Oncology Group Study JCOG0404)

Abstract

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Laparoscopic multivisceral resection for advanced colorectal cancer: multicenter analysis of short-term and long-term outcomes

“…Laparoscopically assisted colectomy is as safe and effective as open colectomy in patients colorectal cancer [16]. However, it has been reported that the long-term outcomes of laparoscopically assisted colectomy were unfavorable, and it was proposed that this was due to varying levels of pro ciency among institutions [17]. Only a few studies have assessed the long-term outcomes of laparoscopic MVR of advanced colorectal cancers.…”

Prognostic risk factors for pT4 colon cancer: A retrospective cohort study

“…A randomized controlled trial comparing open and laparoscopic surgery for colon cancer (JCOG0404) also found no significant differences in the rate of peritoneal recurrence between the two approaches (20). Conversely, a conflicting study showed an association between the laparoscopic approach and increased risk for peritoneal recurrence (21).…”

Laparoscopic versus open resection for stage II/III rectal cancer in obese patients: A multicenter propensity score‐based analysis of short‐ and long‐term outcomes

“…10,11 Additionally, in the JCOG0404 randomized controlled trial (RCT), which examined survival outcomes following laparoscopic versus open D3 dissection for stage II/III colon cancer, 12 among the obese colorectal cancer patients the prognosis in the laparoscopic surgery group was significantly poorer than that in the open surgery group. 13 Although this trial showed the inferiority of laparoscopic surgery to open surgery in terms of long-term outcomes in obese patients, almost no severely obese patients (with a body mass index…”

“…However, other studies found laparoscopic surgery for rectal cancer in obese patients to be technically more demanding than that in nonobese patients, and extra care was required to lessen the increased risk of developing postoperative complications 10,11 . Additionally, in the JCOG0404 randomized controlled trial (RCT), which examined survival outcomes following laparoscopic versus open D3 dissection for stage II/III colon cancer, 12 among the obese colorectal cancer patients the prognosis in the laparoscopic surgery group was significantly poorer than that in the open surgery group 13 . Although this trial showed the inferiority of laparoscopic surgery to open surgery in terms of long‐term outcomes in obese patients, almost no severely obese patients (with a body mass index [BMI] ≥30 kg/m 2 ) were included, and thus, the type of recurrence could not be examined in detail due to the insufficient number of cases.…”

“… 10 , 11 Additionally, in the JCOG0404 randomized controlled trial (RCT), which examined survival outcomes following laparoscopic versus open D3 dissection for stage II/III colon cancer, 12 among the obese colorectal cancer patients the prognosis in the laparoscopic surgery group was significantly poorer than that in the open surgery group. 13 Although this trial showed the inferiority of laparoscopic surgery to open surgery in terms of long‐term outcomes in obese patients, almost no severely obese patients (with a body mass index [BMI] ≥30 kg/m 2 ) were included, and thus, the type of recurrence could not be examined in detail due to the insufficient number of cases. In the present study, we focused on rectal cancer surgery, which is thought to be more difficult to perform than that for colon cancer, which was the subject of the JCOG0404 trial.…”