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International Journal of Colorectal Disease

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01-11-2016 | Original Article

Laparoscopic vs. open surgery for T4 colon cancer: A propensity score analysis

Authors: Nicola de’Angelis, Giulio Cesare Vitali, Francesco Brunetti, Charles-Henri Wassmer, Charlotte Gagniere, Giacomo Puppa, Christophe Tournigand, Frédéric Ris

Published in: International Journal of Colorectal Disease | Issue 11/2016

Abstract

Purpose

The study aimed to compare, using propensity score matching (PSM) analyses, the short- and long-term results of laparoscopic colectomy (LC) versus open colectomy (OC) in a bicentric cohort of patients with T4 colon cancer.

Methods

This is a retrospective PSM analysis of consecutive patients undergoing elective LC or OC for pT4 colon cancer (TNM stage II/III) between 2005 and 2014.

Results

Overall, 237 patients were selected. After PSM, 106 LC-and 106 OC-matched patients were compared. LC was associated with longer operative time and lower blood loss than OC (220 vs. 190 min, p < 0.0001; 116 vs. 150 mL, p = 0.002, respectively). LC patients showed a faster recovery, which translated into a shorter hospital stay compared to OC (10.5 vs. 15.3 days, p < 0.0001). Conversion was required in 13 (12.2 %) LC patients. No group difference was observed for 30- and 90-day mortality. R0 resection was achieved in the majority of LC and OC patients (93.9 %). The 1-, 3-, and 5-year overall survival was 99, 76.8, and 58.6 %, respectively, for the LC group and 98, 70.1, and 59.9 %, respectively, for the OC group (p = 0.864). The 1-, 3-, and 5-year disease-free survival was 86.3, 66, 57.6 %, respectively, for the LC group and 79.1, 55.1, and 50.2 % for the OC group (p = 0.261).

Conclusion

With an acceptable conversion rate, laparoscopy can achieve complete oncologic resections of T4 colon cancer similar to open surgery and can be considered a safe and feasible alternative approach that confers the advantage of a faster recovery.

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Title: Laparoscopic vs. open surgery for T4 colon cancer: A propensity score analysis
Authors: Nicola de’Angelis
Giulio Cesare Vitali
Francesco Brunetti
Charles-Henri Wassmer
Charlotte Gagniere
Giacomo Puppa
Christophe Tournigand
Frédéric Ris
Publication date: 01-11-2016
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Colorectal Disease / Issue 11/2016
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-016-2646-y

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Springer Medicine

Laparoscopic vs. open surgery for T4 colon cancer: A propensity score analysis

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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