| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | Surgical Endoscopy | ||||
| Publisher: | Springer | ||||
| Place of Publication: | NEW YORK | ||||
| Volume: | 31 | ||||
| Number of Issue or Book Chapter: | 6 | ||||
| Page Range: | pp. 2586-2595 | ||||
| Date: | 2017 | ||||
| Institutions: | Medicine > Zentren des Universitätsklinikums Regensburg > Tumorzentrum e.V. Medicine > Institut für Epidemiologie und Präventivmedizin > Tumorzentrum e.V. | ||||
| Identification Number: |
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| Keywords: | COMPLETE MESOCOLIC EXCISION; RANDOMIZED CONTROLLED-TRIALS; LONG-TERM OUTCOMES; OPEN COLECTOMY; ASSISTED RESECTION; COLORECTAL-CANCER; SURVIVAL; METAANALYSIS; MORTALITY; LIGATION; Minimal invasive surgery; Laparoscopic surgery; Colon cancer; Cancer registry; Long-term survival | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 38949 |
Web of ScienceAbstract
The long-term outcomes after laparoscopic surgery for colon cancer remain debatable, as randomized trials have reported similar outcomes for open and laparoscopic surgery but population-based data are scarce. Thus, it is unclear whether, outside of clinical trials, laparoscopic surgery that is performed as a standard clinical treatment has detrimental effects on patients' long-term survival. This ...
Abstract
The long-term outcomes after laparoscopic surgery for colon cancer remain debatable, as randomized trials have reported similar outcomes for open and laparoscopic surgery but population-based data are scarce. Thus, it is unclear whether, outside of clinical trials, laparoscopic surgery that is performed as a standard clinical treatment has detrimental effects on patients' long-term survival. This study examined a unified database of 30 German regional cancer registries for patients with colorectal cancer who were diagnosed between 2003 and 2011. Among 216,682 patients with colorectal carcinoma, we identified 37,068 patients with Union for International Cancer Control stage I-III colon carcinoma (> 12 cm from the anal verge), including 3825 patients (10.38 %) who underwent laparoscopic surgery. Multivariate Cox regression analyses were also used to evaluate factors that influenced the likelihood of a patient undergoing laparoscopic surgery. Kaplan-Meier analysis with the log-rank test was used to analyse differences in short- and long-term survival outcomes after open or laparoscopic surgery. Younger age, lower T-stage, and left-sided surgery were independent predictors of the patient undergoing laparoscopic surgery (all, p < 0001). The 30-day mortality rate was significantly lower for patients who underwent laparoscopic surgery for left-sided tumours (odds ratio [OR] 0.49; 95 % confidence interval [CI] 0.33-0.77). Compared to open surgery, laparoscopic surgery was a significant and independent predictor of prolonged long-term survival for right- and left-sided surgeries (right-side, OR 0.67; 95 % CI 0.56-0.82; left-sided, OR 0.70; 95 % CI 0.62-0.78). Our results indicate that laparoscopic surgery provides favourable outcomes even when used outside controlled trials and should be considered as a standard treatment for patients with colon cancer.
Metadata last modified: 25 Nov 2020 15:45
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