Abstract
Background: Colorectal cancer (CRC) is a leading cause of mortality worldwide and in the UK. Surgical resection is the main curative treatment modality available and using a laparoscopic vs. an open approach may have a direct influence on the inflammatory response, influencing cancer biology and potentially the recurrence kinetics by promoting cancer growth. Methods: This systematic review aims to compare laparoscopic with open surgery for the treatment of colon cancer with a specific focus on the moment of the recurrence. We included randomised controlled trials in intended curative surgery for colon cancer in adults. Interventions: Studies investigating laparoscopic vs. open resection as an intended curative treatment for patients with confirmed carcinoma of the colon. The two co-primary outcomes were the time to recurrence and the overall survival (OS) and disease-free survival (DFS) at three and five years. Meta-analyses were done on the mean differences. Results: After selection, we reviewed ten randomised controlled trials. Most of the trials did not display a statistically significant difference in either DFS or OS at three or at five years when comparing laparoscopic to open surgery. Groups did not differ for the OS and DFS, especially regarding the time needed to observe the median recurrence rate. The quality of evidence (GRADE) was moderate to very low. Conclusion: We observed no difference in the recurrence kinetics, OS or DFS at three or five years when comparing laparoscopic to open surgery in colon cancer.
Highlights
IntroductionAccording to Cancer Research UK [2], it is the 4th most common cancer in the UK, constituting 11% of all new cancer diagnoses
This paper aims to conduct a systematic review with meta-analysis, using available literature on randomised controlled trials (RCTs) across multiple databases, to compare the effectiveness of laparoscopic versus open surgery for the intended curative resection of colon cancer in adults
In one case we found a second publication from the same trial concerning it was not possible obtain theincluding raw data only fromdata the authors, we extracted data from colorectal cancer beingtopublished for left colon cancer
Summary
According to Cancer Research UK [2], it is the 4th most common cancer in the UK, constituting 11% of all new cancer diagnoses It is the second most common cause of cancer mortality in the UK. Colorectal cancer (CRC) is a leading cause of mortality worldwide and in the UK. Surgical resection is the main curative treatment modality available and using a laparoscopic vs an open approach may have a direct influence on the inflammatory response, influencing cancer biology and potentially the recurrence kinetics by promoting cancer growth. Methods: This systematic review aims to compare laparoscopic with open surgery for the treatment of colon cancer with a specific focus on the moment of the recurrence. Interventions: Studies investigating laparoscopic vs open resection as an intended curative treatment for patients with confirmed carcinoma of the colon. The two co-primary outcomes were the time to recurrence and the overall survival (OS)
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