Clinical outcomes of laparoscopic versus open surgery for primary tumor resection in patients with stage IV colorectal cancer with unresectable metastasis.

Abstract

The aim of this study was to compare the clinical outcomes of laparoscopic surgery with those of open surgery in patients with colorectal cancer and unresectable metastasis. We retrospectively reviewed the medical records of patients who underwent primary tumor resection of colorectal cancer with unresectable metastasis between January 2001 and December 2010. Of 280 patients, 61 underwent laparoscopic surgery and 219 underwent open surgery. Regarding the short-term outcomes, the amount of blood loss was lower in the laparoscopic group (P=0.014), although the operation was longer in the laparoscopic group (P=0.003). The times to flatus (P<0.001), liquid food intake (P<0.001), and the duration of hospital stay (P<0.001) were shorter in the laparoscopic group. The complication rate was lower in the laparoscopic group than in the open group (P=0.043). Although the overall survival was significantly better in the laparoscopic group in a univariate analysis, there was no significant difference in the overall survival between the two groups in a multivariate analysis (P=0.482). Laparoscopic surgery seems to be a safe and feasible option, with short-term benefit for primary tumor resection in patients with stage IV colorectal cancer with unresectable metastasis.