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Surgical Endoscopy
Published in: Surgical Endoscopy 10/2017

01-10-2017

Midterm follow-up of a randomized trial of open surgery versus laparoscopic surgery in elderly patients with colorectal cancer

Authors: Atsushi Ishibe, Mitsuyoshi Ota, Shoichi Fujii, Yusuke Suwa, Shinsuke Suzuki, Hirokazu Suwa, Masashi Momiyama, Jun Watanabe, Kazuteru Watanabe, Masataka Taguri, Chikara Kunisaki, Itaru Endo

Published in: Surgical Endoscopy | Issue 10/2017

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Abstract

Background

Laparoscopic surgery has been widely accepted for the treatment of colorectal cancer; however, long-term outcomes in elderly patients remain controversial. The midterm results of a randomized trial comparing open surgery with laparoscopic surgery in elderly patients with colorectal cancer are presented.

Methods

This was a randomized trial comparing open surgery with laparoscopic surgery in elderly patients with colorectal cancer. The primary outcome was complication rate, and secondary outcomes included 3-year recurrence-free survival and overall survival. A total of 200 patients were randomly assigned to open surgery or laparoscopic surgery between 2008 and 2012. The main study objective was to compare the midterm outcomes of open surgery with those of laparoscopic surgery in elderly patients with colorectal cancer. This trial is registered with Clinical Trials.gov (NCT01862562).

Results

There were no differences between the laparoscopic surgery group and open surgery group in the 3-year overall survival rate (91.5% for laparoscopic surgery vs. 90.6% for open surgery, p = 0.638) or the 3-year recurrence-free survival rate (84.8% for laparoscopic surgery vs. 88.2% for open surgery, p = 0.324). The local recurrence rate was significantly higher in the laparoscopic surgery group than in the open surgery group in rectal cancer (13.8% for laparoscopic surgery vs. 0% for open surgery, p = 0.038). In subgroup analysis according to tumor location, there were no significant differences in the 3-year overall survival rate or 3-year recurrence-free survival rate between the two treatment groups.

Conclusion

The midterm outcomes of laparoscopic surgery are similar to those of open surgery in elderly patients with colorectal cancer.
Literature
1.
Group CCC (2000) Surgery for colorectal cancer in elderly patients: a systematic review. The Lancet 356(9234):968–974CrossRef
2.
National Cancer Center Japan PCSRCf, Cancer Control and Information Services CIS.
3.
Green BL, Marshall HC, Collinson F, Quirke P, Guillou P, Jayne DG, Brown JM (2013) Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg 100(1):75–82CrossRefPubMed
4.
Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Eng J Med; 350(20): 2050–2059CrossRef
5.
Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10(1):44–52CrossRefPubMed
6.
Kitano S, Inomata M, Sato A, Yoshimura K, Moriya Y (2005) Randomized controlled trial to evaluate laparoscopic surgery for colorectal cancer: Japan Clinical Oncology Group Study JCOG 0404. Jpn J Clin Oncol 35(8):475–477CrossRefPubMed
7.
Alves A, Panis Y, Mathieu P, Mantion G, Kwiatkowski F, Slim K. (2005) Postoperative mortality and morbidity in French patients undergoing colorectal surgery: results of a prospective multicenter study. Archives Surg 140(3): 278–283, discussion 284.CrossRef
8.
Duron JJ, Duron E, Dugue T, Pujol J, Muscari F, Collet D, Pessaux P, Hay JM (2011) Risk factors for mortality in major digestive surgery in the elderly: a multicenter prospective study. Ann Surg 254(2):375–382CrossRefPubMed
9.
Fujii S, Ishibe A, Ota M, Yamagishi S, Watanabe K, Watanabe J, Kanazawa A, Ichikawa Y, Oba M, Morita S, Hashiguchi Y, Kunisaki C, Endo I (2014) Short-term results of a randomized study between laparoscopic and open surgery in elderly colorectal cancer patients. Surg Endosc 28(2):466–476CrossRefPubMed
10.
Vignali A, Di Palo S, Tamburini A, Radaelli G, Orsenigo E, Staudacher C (2005) Laparoscopic vs. open colectomies in octogenarians: a case-matched control study. Dis Colon Rectum 48(11):2070–2075CrossRefPubMed
11.
Frasson M, Braga M, Vignali A, Zuliani W, Di Carlo V (2008) Benefits of laparoscopic colorectal resection are more pronounced in elderly patients. Dis Colon Rectum 51(3):296–300CrossRefPubMed
12.
Lian L, Kalady M, Geisler D, Kiran RP (2010) Laparoscopic colectomy is safe and leads to a significantly shorter hospital stay for octogenarians. Surg Endosc 24(8):2039–2043CrossRefPubMed
13.
Vallribera Valls F, Landi F, Espin Basany E, Sanchez Garcia JL, Jimenez Gomez LM, Marti Gallostra M, Salgado Cruz L, Armengol Carrasco M (2014) Laparoscopy-assisted versus open colectomy for treatment of colon cancer in the elderly: morbidity and mortality outcomes in 545 patients. Surg Endosc 28(12):3373–3378CrossRefPubMed
14.
Niitsu H, Hinoi T, Kawaguchi Y, Ohdan H, Hasegawa H, Suzuka I, Fukunaga Y, Yamaguchi T, Endo S, Tagami S, Idani H, Ichihara T, Watanabe K, Watanabe M. (2015) Laparoscopic surgery for colorectal cancer is safe and has survival outcomes similar to those of open surgery in elderly patients with a poor performance status: subanalysis of a large multicenter case-control study in Japan. J Gastroenterol 51(1):43–54
15.
Tokuhara K, Nakatani K, Ueyama Y, Yoshioka K, Kon M (2016) Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly: a prospective cohort study. Int J Surg 27:66–71CrossRefPubMed
16.
Moon SY, Kim S, Lee SY, Han EC, Kang SB, Jeong SY, Park KJ, Oh JH. (2016) Laparoscopic surgery for patients with colorectal cancer produces better short-term outcomes with similar survival outcomes in elderly patients compared to open surgery. Cancer med 5(6):1047–1054CrossRefPubMedPubMedCentral
17.
Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM, Group UMCT (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. Jclin oncol 25(21):3061–3068CrossRef
18.
West NP, Kobayashi H, Takahashi K, Perrakis A, Weber K, Hohenberger W, Sugihara K, Quirke P (2012) Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J clin oncol 30(15):1763–1769CrossRefPubMed
19.
Heald RJ (1979) A new approach to rectal cancer. Br J Hosp Med 22(3):277–281PubMed
20.
Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. The Lancet 365(9472):1718–1726CrossRef
21.
Fleshman J, Branda M, Sargent DJ, Boller AM, George V, Abbas M, Peters WR Jr, Maun D, Chang G, Herline A, Fichera A, Mutch M, Wexner S, Whiteford M, Marks J, Birnbaum E, Margolin D, Larson D, Marcello P, Posner M, Read T, Monson J, Wren SM, Pisters PW, Nelson H (2015) Effect of laparoscopic-assisted resection vs open resection of stage II or III rectal cancer on pathologic outcomes: The ACOSOG Z6051 randomized clinical trial. Jama 314(13):1346–1355CrossRefPubMedPubMedCentral
22.
Moriya Y, Sugihara K, Akasu T, Fujita S (1997) Importance of extended lymphadenectomy with lateral node dissection for advanced lower rectal cancer. World J Surg 21(7):728–732CrossRefPubMed
23.
Takahashi T, Ueno M, Azekura K, Ohta H (2000) Lateral node dissection and total mesorectal excision for rectal cancer. Dis Colon Rectum 43(10 Suppl):S59–S68CrossRefPubMed
24.
Sugihara K, Kobayashi H, Kato T, Mori T, Mochizuki H, Kameoka S, Shirouzu K, Muto T (2006) Indication and benefit of pelvic sidewall dissection for rectal cancer. Dis Colon Rectum 49(11):1663–1672CrossRefPubMed
Metadata
Title
Midterm follow-up of a randomized trial of open surgery versus laparoscopic surgery in elderly patients with colorectal cancer
Authors
Atsushi Ishibe
Mitsuyoshi Ota
Shoichi Fujii
Yusuke Suwa
Shinsuke Suzuki
Hirokazu Suwa
Masashi Momiyama
Jun Watanabe
Kazuteru Watanabe
Masataka Taguri
Chikara Kunisaki
Itaru Endo
Publication date
01-10-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 10/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5418-z

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