Outcomes of laparoscopic surgery for pathological T4 colon cancer

Lee

et al. 2020

Preprint

Background: Laparoscopic surgery for T4 colon cancer may be safe in selected patients. We hypothesized that small tumor size might preoperatively predict a good laparoscopic surgery outcome. Herein we compared the clinicopathologic and oncologic outcomes of laparoscopic and open surgery in small T4 colon cancer. Methods: In a retrospective multicenter study, we reviewed the data of 449 patients, including 117 patients with tumors ≤ 4.0 cm who underwent surgery for T4 colon cancer between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open groups. Survival curves were estimated using the Kaplan–Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards model . A p < 0.05 was considered statistically significant. Results: Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (median [range]: 50 [0–700] vs. 100 [0–4000] mL, p < 0.001; 8 vs. 10 days, p < 0.001; and 18.0 vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in 3-year overall survival or disease-free survival (86.6 vs. 83.2%, p = 0.180 and 71.7 vs. 75.1%, p = 0.720, respectively). Among patients with tumor size ≤4.0 cm, blood loss was significantly lower in the laparoscopic group than in the open group (median [range]: 50 [0–530] vs. 50 [0–1000] mL, p = 0.003). Despite no statistical difference observed in the 3-year overall survival rate (83.3 vs. 78.7%, p = 0.538), the laparoscopic group had a significantly higher 3-year disease-free survival rate (79.2 vs. 53.2%, p = 0.012). Conclusions: Laparoscopic surgery showed similar outcomes to open surgery in T4 colon cancer patients , and may have favorable short-term oncologic outcomes in patients with tumors ≤4.0 cm.

Section: Discussionmentioning

confidence: 99%

Favorable short-term oncologic outcomes following laparoscopic surgery for small T4 colon cancer : a multicenter comparative study

Lee

et al. 2020

Preprint

“…Laparoscopic surgery is better than open surgery in regard to the perioperative outcome. In previous studies comparing laparoscopic and open surgery in T4 colon cancer, laparoscopic surgery was associated with less intraoperative blood loss [1,16,17], which has been proven to be a predictor of longterm survival [18,19]. Some studies have shown that hospital stays are shorter in patients who undergo laparoscopic surgery [20,21].…”

Section: Discussionmentioning

confidence: 99%

Improved Oncologic Outcomes Following Laparoscopic Surgery for Small T4 Colon Cancer : A Multi-center Comparative Study

Lee

et al. 2020

Preprint

Background: Laparoscopic surgery for T4 colon cancer may be safe in selected patients. Based on the theory that small tumor size might preoperatively predict a good laparoscopic surgery outcome, we herein compare the clinicopathologic and oncologic outcomes of open and laparoscopic surgery in small T4 colon cancer.Methods: In a retrospective multicenter study, we reviewed the data of 449 patients, including 117 patients with tumors ≤4 cm, who underwent T4 colon cancer surgery between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open surgery groups.Results: Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (86 mL vs. 278 mL, p < 0.001; 10.0 days vs. 12.5 days, p = 0.003; and 18.0% vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in overall survival (OS) and 3-year disease-free survival (DFS; 87.8% vs. 83.2%, p = 0.117; 69.5% vs. 68.1%, p = 0.408, respectively). Among patients with tumors of size ≤4 cm, blood loss was lower in the laparoscopic surgery group than in the open group (80 mL vs. 208 mL, p = 0.001); despite no statistical difference observed in the 3-year OS (84.4% vs 78.7%, p = 0.442), the laparoscopic group had a better 3-year DFS (73.8% vs. 46.0%, p = 0.004).Conclusions: Laparoscopic surgery showed similar outcomes to open surgery in T4 colon cancer patients, and may have favorable short-term oncologic outcomes in patients with small T4 tumors.

“…Laparoscopic surgery is better than open surgery in regard to perioperative outcomes. In previous studies [ 1 , 16 , 17 ] comparing laparoscopic and open surgery in T4 colon cancer, laparoscopic surgery was associated with less intraoperative blood loss, which has been proven to be a predictor of long-term survival [ 18 , 19 ]. Some studies [ 20 , 21 ] have shown that hospital stays are shorter in patients who undergo laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Favorable short-term oncologic outcomes following laparoscopic surgery for small T4 colon cancer: a multicenter comparative study

et al. 2020

Background Laparoscopic surgery for T4 colon cancer may be safe in selected patients. We hypothesized that small tumor size might preoperatively predict a good laparoscopic surgery outcome. Herein, we compared the clinicopathologic and oncologic outcomes of laparoscopic and open surgery in small T4 colon cancer. Methods In a retrospective multicenter study, we reviewed the data of 449 patients, including 117 patients with tumors ≤ 4.0 cm who underwent surgery for T4 colon cancer between January 2014 and December 2017. We compared the clinicopathologic and 3-year oncologic outcomes between the laparoscopic and open groups. Survival curves were estimated using the Kaplan–Meier method and compared using the log-rank test. Univariate and multivariate analyses were performed using the Cox proportional hazards model. A p < 0.05 was considered statistically significant. Results Blood loss, length of hospital stay, and postoperative morbidity were lower in the laparoscopic group than in the open group (median [range], 50 [0–700] vs. 100 [0–4000] mL, p < 0.001; 8 vs. 10 days, p < 0.001; and 18.0 vs. 29.5%, p = 0.005, respectively). There were no intergroup differences in 3-year overall survival or disease-free survival (86.6 vs. 83.2%, p = 0.180, and 71.7 vs. 75.1%, p = 0.720, respectively). Among patients with tumor size ≤ 4.0 cm, blood loss was significantly lower in the laparoscopic group than in the open group (median [range], 50 [0–530] vs. 50 [0–1000] mL, p = 0.003). Despite no statistical difference observed in the 3-year overall survival rate (83.3 vs. 78.7%, p = 0.538), the laparoscopic group had a significantly higher 3-year disease-free survival rate (79.2 vs. 53.2%, p = 0.012). Conclusions Laparoscopic surgery showed similar outcomes to open surgery in T4 colon cancer patients and may have favorable short-term oncologic outcomes in patients with tumors ≤ 4.0 cm.