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

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International Journal of Colorectal Disease Aims and scope Submit manuscript

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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Acknowledgments

The author would like to thank Dr. Maria Clotilde Carra for her help and support in the statistical analysis.

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Authors and Affiliations

  1. Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Créteil, France

    Nicola de’Angelis & Francesco Brunetti

  2. Divisions of Transplant and Abdominal Surgery, Department of Surgery, University of Geneva Hospitals, Geneva, Switzerland

    Giulio Cesare Vitali, Charles-Henri Wassmer & Frédéric Ris

  3. Department of Gastroenterology and Digestive Endoscopy, Henri Mondor Hospital, AP-HP, Creteil, France

    Charlotte Gagniere

  4. Division of Clinical Pathology, University of Geneva Hospitals, Geneva, Switzerland

    Giacomo Puppa

  5. Medical Oncology Department, Henri Mondor Hospital, AP-HP, Créteil, France

    Christophe Tournigand

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  1. Nicola de’Angelis
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Correspondence to Nicola de’Angelis.

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The study was conducted in accordance with the ethical principles ascertained in the Declaration of Helsinki.

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The authors declare that they have no conflict of interest.

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de’Angelis, N., Vitali, G.C., Brunetti, F. et al. Laparoscopic vs. open surgery for T4 colon cancer: A propensity score analysis . Int J Colorectal Dis 31, 1785–1797 (2016). https://doi.org/10.1007/s00384-016-2646-y

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