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A propensity score-matching analysis comparing the oncological outcomes of laparoscopic and open surgery in patients with Stage I/II colon and upper rectal cancers

Surgery Today volume 45, pages 700–707 (2015)Cite this article

Abstract

Purpose

Previous studies from Western countries have shown similar survival outcomes after both open and laparoscopic resections. In Japan, radical D3 dissections performed by open resection have been routinely performed for ≥T2- or ≥N1-stage cancers, and relatively favorable survival outcomes were obtained. This study compared the survival in patients with Stage I/II colon and upper rectal cancers undergoing laparoscopic and open resection.

Methods

A total of 145 patients were initially enrolled. Propensity score matching was applied to assemble a study cohort. D2 lymph node dissection for T1 cancer and D3 for ≥T2- and ≥N1-stage cancers were applied. The primary outcome measure was the disease-free survival; the cancer-specific and overall survival rates were secondary outcomes.

Results

A total of 64 patients were matched for the analysis. The length of hospitalization, postoperative complication rates, number of lymph nodes removed and surgical margins were similar between the groups. The disease-free survival following laparoscopic surgery was better than that following open surgery, but the difference was not statistically significant. Neither the cancer-specific nor overall survival rates following laparoscopic surgery were inferior to those associated with open surgery.

Conclusions

The outcomes of the laparoscopic approach were comparable to those for open surgeries accompanied by radical lymph node dissection.

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Conflict of interest

We declare that there are no conflicts of interest associated with this study, and that the trial was conducted independently.

Author information

Affiliations

  1. Department of Surgery, Japanese Red Cross Hadano Hospital, 1-1 Tatenodai, Hadano, Kanagawa, 257-0017, Japan

    Masakatsu Numata, Kimiatsu Hasuo, Kentaro Hara, Yukio Maezawa, Keisuke Kazama, Hitoshi Inari, Ken Takata & Yasuyuki Jin

  2. Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Norio Yukawa, Takashi Oshima, Yasushi Rino & Munetaka Masuda

  3. Department of Biostatistics and Epidemiology, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan

    Masataka Taguri

Authors
  1. Masakatsu Numata
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  2. Kimiatsu Hasuo
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  3. Kentaro Hara
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  4. Yukio Maezawa
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  5. Keisuke Kazama
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  6. Hitoshi Inari
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  7. Ken Takata
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  8. Yasuyuki Jin
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  9. Norio Yukawa
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  10. Takashi Oshima
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  11. Yasushi Rino
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  12. Masataka Taguri
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  13. Munetaka Masuda
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Corresponding author

Correspondence to Masakatsu Numata.

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Numata, M., Hasuo, K., Hara, K. et al. A propensity score-matching analysis comparing the oncological outcomes of laparoscopic and open surgery in patients with Stage I/II colon and upper rectal cancers. Surg Today 45, 700–707 (2015). https://doi.org/10.1007/s00595-014-0954-9

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  • DOI: https://doi.org/10.1007/s00595-014-0954-9

Keywords

  • Colorectal cancer
  • Laparoscopic surgery
  • Propensity-matching analysis
  • Long-term outcomes