Long-term outcome in laparoscopic colectomy for colon cancer

Kiichi Sugimoto, Kazuhiro Sakamoto, Yuichi Tomiki, Michitoshi Goto, Yutaka Kojima, Hiromitsu Komiyama, Makoto Takahashi, Shun Ishiyama, Shingo Ito, Masaya Kawai, Kazuhiro Takehara, Yoshihiko Tashiro, Shinya Munakata, Jun Aoki, Yu Okazawa, Rina Takahashi, Kousuke Mizukoshi. Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.

Introduction : Laparoscopic colectomy (LAC) for colon cancer has spread widely and we have expanded the indication for LAC. We retrospectively considered the effectiveness of LAC based on TNM stage classification.

Methods : One hundred twenty three patients who underwent laparoscopic colectomy (LAC group) and three hundred seventy three patients who underwent open colectomy (OC group) for colon cancer at our department between 2000 and 2010 were enrolled in the present study. The recurrence-free survival rate and the cancer-specific survival rate were calculated using the Kaplan-Meier method and univariate analyses were performed using the log-rank test.

Results : Among the patients classified as TNM IIA, the 5-year recurrence-free survival rates in LAC group and OC group were 81.7% and 85.6%, respectively. There was no significant difference between the two groups (P=0.72). The 5-year cancer-specific survival rates in LAC group and OC group were 100% and 94.8%, respectively. There was no significant difference between the two groups (P=0.08). Among the patients classified as IIB, the 5-year recurrence-free survival rates in LAC group and OC group were 66.7% and 69.4%, respectively. There was no significant difference between the two groups (P=0.88). The 5-year cancer-specific survival rates in LAC group and OC group were 100% and 83.1%, respectively. There was no significant difference between the two groups (P=0.82). Among the patients classified as IIC, there was no patient in LAC group. The 5-year recurrence-free survival rates in OC group were 50.0%. The 5-year cancer-specific survival rates in OC group were 50.0%. Among the patients classified as TNM IIIA, the 5-year recurrence-free survival rates in LAC group and OC group were 72.3% and 100%, respectively. There was a significant difference between the two groups (P=0.006). The 5-year cancer-specific survival rates in LAC group and OC group were 94.7% and 100%, respectively. There was no significant difference between the two groups (P=0.26). Among the patients classified as IIIB, the 5-year recurrence-free survival rates in LAC group and OC group were 77.6% and 64.8%, respectively. There was no significant difference between the two groups (P=0.08). The 5-year cancer-specific survival rates in LAC group and OC group were 85.5% and 79.7%, respectively. There was no significant difference between the two groups (P=0.38). Among the patients classified as IIIC, the 5-year recurrence-free survival rates in LAC group and OC group were 22.2% and 38.1%, respectively. There was no significant difference between the two groups (P=0.58). The 5-year cancer-specific survival rates in LAC group and OC group were 0% and 49.8%, respectively. There was no significant difference between the two groups (P=0.79).

Discussion : It is suggested that LAC for TNM stage II / III colon cancer can be permitted because there was no difference in cancer-specific survival rates between LAC group and OC group.

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