Multicenter study of laparoscopic surgery for colon cancer in Japan

Objective: To evaluate short and long-term results of laparoscopic surgery for colon cancer, we conducted a nationwide survey and prospective randomized controlled trial (RCT) in Japan, supported by Grants for Clinical Cancer Research from the Ministry of Health, Labor and Welfare in Japan.
A retrospective nationwide survey: The study group comprised 2036 patients undergoing laparoscopic surgery for colon cancer during the period 1993 to 2002 in 12 advancing laparoscopic surgical units. In 1495 patients with colon cancer, the morbidity and mortality rate was 13% and 1%. Recurrent rate was 4% and the 5-year survival rate was 96.7% for stage I, 94.8% for stage II, and 79.6% for stage III disease. A retrospective, multicenter study demonstrates that laparoscopic surgery for colon cancer is feasible in terms of short and long-term outcomes in Japan.
A randomized controlled trial: A RCT (JCOG0404) has started on November in 2004 to evaluate laparoscopic vs open surgery as the optimal treatment for T3 or deeper colon cancer. Surgeons in 27 specialized institutions will recruit 818 patients. Primary endpoint is overall survival, and secondary endpoints are disease-free survival, short clinical outcome, adverse events, conversion rate from laparoscopic to open approach and completion rate of laparoscopic surgery. To control the quality of surgeries, central review of surgical procedure by photographs is performed in all patients. Total@registrated cases reach to 620 now.
Conclusions: A long-term oncological outcome of laparoscopic surgery for colon cancer is to be confirmed by our on-going randomized controlled trial in Japan.


Session: Podium Presentation

Program Number: S097

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