Shingo Ito1, Kazuhiro Sakamoto1, Ryo Ohta2, Yuki Tsuchiya1, Hirokazu Matsuzawa1, Ryoichi Tsukamoto1, Shinya Munakata1, Masaya Kawai1, Koichiro Niwa1, Shun Ishiyama1, Kiichi Sugimoto1, Hirohiko Kamiyama1, Makoto Takahashi1, Yutaka Kojima1, Yuichi Tomiki1. 1Department of Coloproctological Surgery, Faculty of Medicine, Juntendo University, 2Department of Gastroenterological Surgery, Kawasaki Saiwai Hospital, Kanagawa, Japan.
INTRODUCTION: Laparoscopic surgery has also developed as a commonly accepted surgical procedure for advanced colorectal cancer. There are conflicting data on the influence of laparoscopic surgery on survival benefits. However, advantages of primary tumor resection by the laparoscopic surgery in patients with metastatic colorectal cancer are still obscure. The aim of this study was to compare the long-term outcomes of laparoscopic surgery with those of open surgery in patients with metastatic colorectal cancer.
METHODS AND PROCEDURES: We retrospectively reviewed a total 149 consecutive stage IV patients who underwent primary tumor resection of colorectal cancer between January 2007 and December 2014.
RESULTS: The median duration of observation was 21 ± 23.4 months. The five-year overall survival rate was 12.1% in all patients with stage IV colorectal cancer, with median survival times of 23 months. Of 149 patients, 44 underwent laparoscopic surgery and 105 underwent open surgery. There were no deaths within 30 days after surgery in the laparoscopic group. Five patients (17.2%) in the laparoscopic group required conversion to open surgery because of bulky tumors. Seven patients (15.9%) in the laparoscopic group required conversion to open surgery because of bulky tumors. The five-year overall survival rate was 6.8% in the laparoscopic group and 14.5% in the open group, with median survival times of 30 and 21 months, respectively (P = 0.22). Although the median survival times of laparoscopic surgery were longer than open surgery, laparoscopic surgery was not significantly associated with the overall survival.
CONCLUSION: Laparoscopic surgery seems to be a safe and feasible option, with long-term benefit for primary tumor resection with metastatic colorectal cancer, but optimal treatment has yet to be defined.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87156
Program Number: P742
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster