Abstract
BackgroundSome recent studies have suggested that laparoscopic surgery for colorectal cancer may provide a potential survival advantage when compared with open surgery. This study aimed to compare cancer-related survivals of patients who underwent laparoscopic or open resection of colon cancer in the same, high volume tertiary center.MethodsPatients who had undergone elective open or laparoscopic surgery for colon cancer between January 2002 and December 2010 were analyzed. A clinical database was prospectively compiled. Survival analysis was calculated by using the Kaplan-Meier method.ResultsA total of 460 resections were performed. There were no significant differences between the laparoscopic (n = 227) and the open group (n = 233) apart from tumor stage: stage I tumors were more frequent in the laparoscopic group whereas stage II tumors were more frequent in the open group. The mean number of harvested lymph nodes was significantly higher in the laparoscopic than in the open group (20.0 ± 0.7 vs 14.2 ± 0.5, P < 0.01). The 5-year cancer-related survival for patients undergoing laparoscopic resection was significantly higher than that following open resections (83.1% vs 68.5%, P = 0.01). By performing a stage-to-stage comparison, we found that the improvement in survival in the laparoscopic group occurred mainly in patients with stage II tumors.ConclusionsOur study shows a survival advantage for patients who had undergone laparoscopic surgery for stage II colon cancer. This may be correlated with a higher number of harvested lymph nodes and thus a better stage stratification of these patients.
Highlights
Some recent studies have suggested that laparoscopic surgery for colorectal cancer may provide a potential survival advantage when compared with open surgery
These authors demonstrated a significantly higher tumor-related survival in patients who Cianchi et al BMC Surgery (2015) 15:33 had undergone laparoscopic surgery when compared with open surgery, and this survival advantage was more pronounced in patients with stage III tumors
From retrospective, non-randomized studies, are in line with these results [11,12,13,14], showing potential survival benefits for patients undergoing laparoscopic surgery compared with historical series of conventional open surgery
Summary
Some recent studies have suggested that laparoscopic surgery for colorectal cancer may provide a potential survival advantage when compared with open surgery. Lacy et al [10] have recently reported some unexpected, positive results regarding long-term survival of patients submitted to laparoscopic colon cancer resection within a randomized, controlled trial. These authors demonstrated a significantly higher tumor-related survival in patients who Cianchi et al BMC Surgery (2015) 15:33 had undergone laparoscopic surgery when compared with open surgery, and this survival advantage was more pronounced in patients with stage III tumors. From retrospective, non-randomized studies, are in line with these results [11,12,13,14], showing potential survival benefits for patients undergoing laparoscopic surgery compared with historical series of conventional open surgery
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