Short- and Long-Term Outcomes of Laparoscopic Surgery in Patients with Pathological Stage II and III Colon Cancer

Abstract

In Japan, the safety and long-term outcomes of laparoscopic surgery for advanced colorectal cancer remains a matter of debate. We studied the safety and outcomes of laparoscopic surgery in patients with pathological stage II and III colon cancer. The study group comprised 253 patients with colon cancer who underwent laparoscopic surgery from January 1998 through December 2006. We studied surgical outcomes, invasiveness, safety, recurrence rates, recurrence patterns, and long-term outcomes. Median follow-up was 67 months (range, 7-149). Laparoscopic surgery was converted to open surgery in 5 patients (2%). Postoperative complications occurred in 23 patients (9%); wound infections were most common (11 patients, 4.3%), followed by ileus (5 patients, 1.9%). Recurrence developed in 66 patients (26%). Liver and lung metastases were the most common types of recurrence; there was no port-site recurrence. The 10-year recurrence-free survival rate and the overall survival rate were respectively 92.9% and 93.3% in stage II disease, 82.7% and 82.9% in stage IIIA and IIIB disease, and 70.3% and 68.6% in stage IIIC disease. In patients with pathological stage II and III colon cancer, laparoscopic surgery is safe, minimally invasive, and has good surgical outcomes, overall survival rates and recurrence-free survival rates. Our results suggest that laparoscopic surgery is a viable treatment option for pathological stage II and III colon cancer.