Skip to main content
Log in

Comparison of short, long-term surgical outcomes and mid-term health-related quality of life after laparoscopic and open resection for colorectal cancer: a case-matched control study

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

A multicenter randomized study is high quality, but it is also true that there are differences between institutions. The quality of treatment is consistent in a single center so comparisons in a retrospective study can be matched for many variables.

Methods

This single-center study examined short-term and long-term outcomes for colorectal cancer in 258 patients who underwent laparoscopic resection (LC) and 258 matched open resection (OC) cases. The health-related qualities of life (HRQOL) at 1–2 years after the operations in 62 patients (35 LC and 27 OC) were compared by SF-36.

Results

The conversion rate was 5.0%. Mean follow-up periods in LC and OC were 62.3 and 62.1 months, respectively. Operation time was longer in LC than in OC, although the difference was not significant in the later period. Bleeding and postoperative stay were reduced in LC. The morbidity rate was 18.6% in LC and 26.4% in OC. The 5-year overall survival in LC and OC were 94.6% vs. 92.0% for stage I, 95.2% vs. 91.8% for stage II, and 80.9% vs. 79.1% for stage III, respectively. The corresponding 5-year disease-free survival were 94.0% vs. 88.4%, 92.1% vs. 84.0%, and 64.3% vs. 65.4%, respectively. Recurrence rates did not differ between groups. In the analysis of HRQOL scores, role physical, bodily pain, social functioning, role emotional, and physical component summary scores in LC were better than in OC.

Conclusions

In LC for colorectal cancer, short-term outcomes except operation time and mid-term HRQOL were better than in OC, and there were no adverse effects relating to long-term outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Explore related subjects

Discover the latest articles and news from researchers in related subjects, suggested using machine learning.

References

  1. Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150

    CAS  PubMed  Google Scholar 

  2. Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopic-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229

    Article  PubMed  Google Scholar 

  3. Leung KL, Kwok SPY, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomized trial. Lancet 363:1187–1192

    Article  PubMed  Google Scholar 

  4. Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison laparoscopic assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059

    Article  Google Scholar 

  5. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM, UK MRC CLASICC Trial Group (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068

    Article  PubMed  Google Scholar 

  6. Kuhry E, Bonjer HJ, Haglind E, Hop WC, Veldkamp R, Cuesta MA, Jeekel J, Påhlman L, Morino M, Lacy A, Delgado S, COLOR Study Group (2005) Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer. Surg Endosc 19:687–692

    Article  CAS  PubMed  Google Scholar 

  7. Schwenk W, Haase O, Günther N, Neudecker J (2005) Methodological quality of randomized controlled trials comparing short-term results of laparoscopic and conventional colorectal resection. Int J Colorectal Dis 22:1369–1376

    Article  Google Scholar 

  8. Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332

    Article  CAS  PubMed  Google Scholar 

  9. Patankar SK, Larach SW, Ferrara A, Williamson PR, Gallagher JT, DeJesus S, Narayanan S (2003) Prospective comparison of laparoscopic vs. open resections for colorectal adenocarcinoma over a ten-year period. Dis Colon Rectum 46:601–611

    Article  PubMed  Google Scholar 

  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 48:2070–2075

    Article  PubMed  Google Scholar 

  11. Baker RP, Titu LV, Hartley JE, Lee PW, Monson JR (2004) A case-control study of laparoscopic right hemicolectomy vs. open right hemicolectomy. Dis Colon Rectum 47:1675–1679

    Article  PubMed  Google Scholar 

  12. Nakamura T, Kokuba Y, Mitomi H, Onozato W, Hatate K, Satoh T, Ozawa H, Ihara A, Watanabe M (2007) Comparison between the oncologic outcome of laparoscopic surgery and open surgery for T1 and T2 rectosigmoidal and rectal carcinoma: matched case-control study. Hepatogastroenterology 54:1094–1097

    PubMed  Google Scholar 

  13. Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G, Clinical Outcomes of Surgical Therapy (COST) Study Group (2002) Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs.open colectomy for colon cancer: a randomized trial. JAMA 287:321–328

    Article  PubMed  Google Scholar 

  14. Braga M, Frasson M, Vignal A, Zuliani W, Civelli V, Di Carlo V (2005) Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival. Dis Colon Rectum 48:2217–2223

    Article  PubMed  Google Scholar 

  15. Fukuhara S, Suzukamo Y (2004) Manual of SF-36v2 Japanese version. Institute for Health Outcomes & Process Evaluation Research, Kyoto

  16. Colorectal Cancer Society (2006) The 7th edition of the Japanese General Rules for clinical and pathological studies on cancer of the colon, rectum and anus. Kanahara Publications, Tokyo, in Japanese

    Google Scholar 

  17. National Cancer Institute. Common terminology criteria for adverse events version 3.0. Available at http://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/ctcaev3.pdf

  18. Kitano S, Inomata M (2009) Is laparoscopic surgery acceptable for advanced colon cancer? Cancer Sci 100:567–571

    Article  CAS  PubMed  Google Scholar 

  19. Kitano S, Kitajima M, Konishi F, Kondo H, Satomi S, Shimizu N, Japanese Laparoscopic Surgery Study Group (2006) A multicenter study on laparoscopic surgery for colorectal cancer in Japan. Surg Endosc 20:1348–1352

    Article  CAS  PubMed  Google Scholar 

  20. Hinojosa MW, Murrell ZA, Konyalian VR, Mills S, Nguyen NT, Stamos MJ (2007) Comparison of laparoscopic vs open sigmoid colectomy for benign and malignant disease at academic medical centers. J Gastrointest Surg 11:1423–1430

    Article  PubMed  Google Scholar 

  21. Steele SR, Brown TA, Rush RM, Martin MJ (2008) Laparoscopic vs open colectomy for colon cancer: results from a large nationwide population-based analysis. J Gastrointest Surg 12:583–591

    Article  PubMed  Google Scholar 

  22. Bilimoria KY, Bentrem DJ, Merkow RP, Nelson H, Wang E, Ko CY, Soper NJ (2008) Laparoscopic-assisted vs. open colectomy for cancer: comparison of short-term outcomes from 121 hospitals. J Gastrointest Surg 12:2001–2009

    Article  PubMed  Google Scholar 

  23. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  Google Scholar 

  24. Leung KL, Yiu RY, Lai PB, Lee JF, Thung KH, Lau WY (1999) Laparoscopic-assisted resection of colorectal carcinoma: five-year audit. Dis Colon Rectum 42:327–333

    Article  CAS  PubMed  Google Scholar 

  25. Hong D, Tablet J, Anvari M (2001) Laparoscopic vs. open resection for colorectal adenocarcinoma. Dis Colon Rectum 44:10–19

    Article  CAS  PubMed  Google Scholar 

  26. Curet MJ, Putrakul K, Pitcher DE, Josloff RK, Zucker KA (2000) Laparoscopically assisted colon resection for colon carcinoma: preoperative results and long-term outcome. Surg Endosc 14:1062–1066

    Article  CAS  PubMed  Google Scholar 

  27. Tsikitis VL, Larson DL, Wolff BG, Kennedy G, Diehl N, Qin R, Dozois EJ, Cima RR (2009) Survival in stage III colon cancer is independent of the total number of lymph nodes retrieved. J Am Coll Surg 208:42–47

    Article  PubMed  Google Scholar 

  28. Hsu TC (2008) Intra-abdominal lesions could be missed by inadequate laparoscopy. Am Surg 74:824–826

    PubMed  Google Scholar 

  29. Wu JS, Jones DB, Guo LW, Brasfield EB, Ruiz MB, Connett JM, Fleshman JW (1998) Effect of pneumoperitoneum on tumor implantation with decreasing tumor inoculum. Dis Colon Rectum 41:141–146

    Article  CAS  PubMed  Google Scholar 

  30. Zayyan KS, Christie-Brown JS, Van Noorden S, Yiu CY, Sellu DP, Mathie RT (2003) Rapid flow carbon dioxide laparoscopy disperses cancer cells into the peritoneal cavity but not the port sites in a new rat model. Surg Endosc 17:273–277

    Article  CAS  PubMed  Google Scholar 

  31. Shen MY, Huang IP, Chen WS, Chang JT, Lin JK (2008) Influence of pneumoperitoneum on tumor growth and pattern of intra-abdominal tumor spreading: in vivo study of a murine model. Hepatogastroenterology 55:947–951

    PubMed  Google Scholar 

  32. Yamamoto S, Yoshimura K, Konishi F, Watanabe M (2008) Phase II trial to evaluate laparoscopic surgery for stage 0/I rectal cancer. Jpn J Clin Oncol 38:497–500

    Article  PubMed  Google Scholar 

  33. Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NZ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC et al (1993) The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 85:365–376

    Article  CAS  PubMed  Google Scholar 

  34. Sprangers MAG, te Velde A, Aaronson NK (1999) The construction and testing of EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38). Eur J Cancer 35:238–247

    Article  CAS  PubMed  Google Scholar 

  35. Psaila J, Bulley SH, Ewings P, Sheffield JP, Kennedy RH (1998) Outcome following laparoscopic resection for colorectal cancer. Br J Surg 85:662–664

    Article  CAS  PubMed  Google Scholar 

  36. Thaler K, Dinnewitzer A, Mascha E, Arrigain S, Weiss EG, Nogueras JJ, Wexner SD (2003) Long-term outcome and health-related quality of life after laparoscopic and open colectomy for benign disease. Surg Endsc 17:1404–1408

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shoichi Fujii.

Additional information

Sources of support

None.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fujii, S., Ota, M., Ichikawa, Y. et al. Comparison of short, long-term surgical outcomes and mid-term health-related quality of life after laparoscopic and open resection for colorectal cancer: a case-matched control study. Int J Colorectal Dis 25, 1311–1323 (2010). https://doi.org/10.1007/s00384-010-0981-y

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-010-0981-y

Keywords