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

Nicola de’Angelis, Giulio Cesare Vitali, Francesco Brunetti, Charles Henri Wassmer, Charlotte Gagniere, Giacomo Puppa, Christophe Tournigand, Frédéric Ris

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)1785-1797
Number of pages13
JournalInternational Journal of Colorectal Disease
Volume31
Issue number11
DOIs
Publication statusPublished - Nov 1 2016

Keywords

  • Colon cancer
  • Laparoscopic colectomy
  • Locally advanced colon cancer
  • Open colectomy
  • Propensity score matching

ASJC Scopus subject areas

  • Gastroenterology

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    de’Angelis, N., Vitali, G. C., Brunetti, F., Wassmer, C. H., Gagniere, C., Puppa, G., Tournigand, C., & Ris, F. (2016). Laparoscopic vs. open surgery for T4 colon cancer: A propensity score analysis. International Journal of Colorectal Disease, 31(11), 1785-1797. https://doi.org/10.1007/s00384-016-2646-y