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Surgical Endoscopy
Published in: Surgical Endoscopy 6/2017

Open Access 01-06-2017

Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer

Authors: Charlotte L. Deijen, Jeanine E. Vasmel, Elly S. M. de Lange-de Klerk, Miguel A. Cuesta, Peter-Paul L. O. Coene, Johan F. Lange, W. J. H. Jeroen Meijerink, Jack J. Jakimowicz, Johannes Jeekel, Geert Kazemier, Ignace M. C. Janssen, Lars Påhlman, Eva Haglind, H. Jaap Bonjer, On behalf of the COLOR (COlon cancer Laparoscopic or Open Resection) study group

Published in: Surgical Endoscopy | Issue 6/2017

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Abstract

Background

Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up.

Methods

Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842).

Results

In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) −10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI −10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI −11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n = 3 vs. open n = 4).

Conclusions

Laparoscopic surgery for non-metastatic colon cancer is associated with similar rates of disease-free survival, overall survival and recurrences as open surgery at 10-year follow-up.
Appendix
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Metadata
Title
Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer
Authors
Charlotte L. Deijen
Jeanine E. Vasmel
Elly S. M. de Lange-de Klerk
Miguel A. Cuesta
Peter-Paul L. O. Coene
Johan F. Lange
W. J. H. Jeroen Meijerink
Jack J. Jakimowicz
Johannes Jeekel
Geert Kazemier
Ignace M. C. Janssen
Lars Påhlman
Eva Haglind
H. Jaap Bonjer
On behalf of the COLOR (COlon cancer Laparoscopic or Open Resection) study group
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/s00464-016-5270-6

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