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Surgical Endoscopy
Published in: Surgical Endoscopy 6/2017

01-06-2017

Laparoscopic surgery in patients with colon cancer: a population-based analysis

Authors: Stefan Benz, Hagen Barlag, Michael Gerken, Alois Fürst, Monika Klinkhammer-Schalke

Published in: Surgical Endoscopy | Issue 6/2017

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Abstract

Background

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.

Methods

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.

Results

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).

Conclusion

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.
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Metadata
Title
Laparoscopic surgery in patients with colon cancer: a population-based analysis
Authors
Stefan Benz
Hagen Barlag
Michael Gerken
Alois Fürst
Monika Klinkhammer-Schalke
Publication date
01-06-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 6/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5266-2

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