Objective: Laparoscopic-assisted surgery for advanced cancer of the colon and rectum remains controversial. Our institute has limited indication of laparoscopic-assisted surgery for Stage III of colorectal cancer. N2 is contra-indication for laparoscopic-assisted surgery. But actual pathological findings revealed pN2 in some cases, because of underdiagnosis of lymph node metastasis. The purpose of this study was to qualify the indication of laparoscopic-assisted surgery for Stage IIIC (Any T, N2, M0) of colorectal cancer.
Method: Out of 423 patients underwent laparoscopic-assisted surgery for colorectal cancer from 1993 to 2006, 18 patients with pN2 were enrolled in this study comparing with pN2 who underwent open surgery.
Results: Mean number of harvested lymph node were 29.6/ 40.5, number of metastatic lymph node were 6.9 / 7.5, recurrence rate was 38.8% / 36.2% in laparoscopic-assisted and open surgery group, respectively. There wereno significant difference between them in mean number of harvested lymph node, metastatic lymph node and recurrence rate. Moreover 5-year survival rate were 87.5% / 55.9% in laparoscopic-assisted and open surgery, respectively (p=0.088).
Conclusion: Laparoscopic-assisted surgery was thought to be adequate procedure for Stage IIIC of colorectal cancer.
Program Number: P111