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Laparoscopic versus open colectomy for TNM stage III colon cancer: results of a prospective multicenter study in Italy

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Abstract

Background and Purpose

There is still debate about the practicality of performing laparoscopic colectomy instead of open colectomy for patients with curable cancer, although laparoscopic surgery is now being performed even for patients with advanced colon cancer. We compared the long-term results of laparoscopic versus open colectomy for TNM stage III carcinoma of the colon in a large series of patients followed up for at least 3 years.

Methods

The subjects of this prospective non-randomized multicentric study were 290 consecutive patients, who underwent open surgery (OS group; n = 164) or laparoscopic surgery (LS group; n = 126) between 1994 and 2005, at one of the four surgical centers. The same surgical techniques were used for the laparoscopic and open approaches to right and left colectomy. The distribution of TNM substages (III A, III B, IIIC) as well as the grading of carcinomas (G1, G2, G3) were similar in each arm of the study. The median follow-up periods were 76.9 and 58.0 months after OS and LS, respectively.

Results

There were 10 (6.1 %) versus 9 (7.1 %) deaths unrelated to cancer, 15 (9.1 %) versus 5 (4 %) cases of local recurrence, 7 (4.2 %) versus 5 (4 %) cases of peritoneal carcinosis, and 37 (22.5 %) versus 14 (11.1 %) cases of metastases in the OS and LS groups, respectively. There was also one case of port-site recurrence after LS (0.8 %). The OS group had a significantly higher probability of local recurrence and metastases (p < 0.001) with a significant higher probability of cancer-related death (p = 0.001) than the LS group.

Conclusions

These findings support that LS is safe and effective for advanced carcinoma of the colon. Although the LS group in this study had a significantly better long-term outcome than the OS group, further investigations are needed to draw a definitive conclusion.

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Conflict of interest

None of the authors have any conflict of interest in connection with the submitted article.

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Authors and Affiliations

  1. Clinica di Chirurgia Generale e Metodologia Chirurgica, Ospedali Riuniti Ancona-Università Politecnica delle Marche, via Conca 1, 60121, Ancona, Italy

    Mario Guerrieri, Roberto Campagnacci & Giovanni Lezoche

  2. Divisione di Chirurgia Generale, Ospedali Riuniti Ancona-Università Politecnica delle Marche, via Conca 1, 60121, Ancona, Italy

    Angelo De Sanctis

  3. Unit of Surgical Oncology, Institute for Research and Cure of Cancer, Candiolo, Italy

    Paolo Massucco & Lorenzo Capussotti

  4. Unit of Surgical Oncology, “SS. Antonio e Biagio e C. Arrigo” Hospital, Alessandria, Italy

    Massimo Summa & Giuseppe Spinoglio

  5. Department of Epidemiology, Biostatistics and Medical Information Technology, Polytechnic University of Marche, Ancona, Italy

    Rosaria Gesuita

  6. Department of General Surgery, Surgical Specialties and Organ Transplantation “Paride Stefanini”, University of Rome La Sapienza, Rome, Italy

    Emanuele Lezoche

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  1. Mario Guerrieri
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  2. Roberto Campagnacci
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  10. Emanuele Lezoche
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Correspondence to Roberto Campagnacci.

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Guerrieri, M., Campagnacci, R., De Sanctis, A. et al. Laparoscopic versus open colectomy for TNM stage III colon cancer: results of a prospective multicenter study in Italy. Surg Today 42, 1071–1077 (2012). https://doi.org/10.1007/s00595-012-0292-8

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  • DOI: https://doi.org/10.1007/s00595-012-0292-8

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