Outcomes of laparoscopic surgery in pathologic T4 colon cancers compared to those of open surgery.

Abstract

Despite the oncologic safety of laparoscopic surgery in colon cancer management, laparoscopy is not regarded as a standard treatment for T4 colon cancer. The aim of this study was to investigate the short-term and long-term oncologic outcomes of laparoscopic surgery in patients with locally advanced colon cancer. From March 2003 to June 2013, a total of 109 consecutive patients with proven pathologic T4 colon cancer were enrolled. These patients were divided into the laparoscopy group (LG, n=52) and the open group (OG, n=57). Perioperative and long-term oncologic outcomes were compared between the two groups. In the LG, open conversion occurred in four patients (7.6%). Combined resection was less commonly performed in the LG (13.5%) than in the OG (36.8%, P=0.005). Operation time was similar between the two groups. In the LG, blood loss (129mL vs. 437mL, P<0.001) and overall complication rate (13.5 vs. 36.8%, P=0.005) were lower and length of hospital stay was shorter (median 7 vs. 17days, P<0.001) than in the OG. The 5-year overall survival rate was 60.7% for the LG and 61.9% for the OG (P=0.817). Local recurrence-free survival did not differ between the groups (88.9% in LG vs. 88.1% in OG, P=0.725). Considering the benefits of early recovery and similar oncologic outcomes, laparoscopic surgery in T4 colon cancer could be a viable option in selected patients.