Long-term oncologic outcomes of laparoscopic versus open resection following stent insertion for obstructing colon cancer: a multi-center retrospective study.

Bae, Sung Uk; Yang, Chun-Seok; Kim, Sohyun; Lim, Dae Ro; Jeong, Woon Kyung; Dong Kim, Dae; Kim, Jae Hwang; Shin, Eung Jin; Lee, Yoo Jin; Lee, Ju Yup; Kim, Nam Kyu; Baek, Seong Kyu
Surgical endoscopy
2019Jan ; 19 ( 3 ) :.
저자 상세정보
Bae, Sung Uk -
Yang, Chun-Seok -
Kim, Sohyun -
Lim, Dae Ro -
Jeong, Woon Kyung -
Dong Kim, Dae -
Kim, Jae Hwang -
Shin, Eung Jin -
Lee, Yoo Jin -
Lee, Ju Yup -
Kim, Nam Kyu -
Baek, Seong Kyu -
ABSTRACT
BACKGROUND: This study compared oncologic outcomes between open and laparoscopic surgery following self-expanding metallic stents insertion for obstructing colon cancer.

METHODS: This retrospective study included 50 patients who underwent open surgery and 44 patients who underwent laparoscopic surgery for obstructing left-sided colon cancer at four tertiary referral hospitals between June 2005 and December 2013.

RESULTS: The median follow-up periods were 48?months and 47?months in the open and laparoscopic groups, respectively. The median operative time, time to soft diet, and length of stay were comparable between the groups. Four cases converted to open surgery (9.1%) in the laparoscopic group. The morbidity within 30?days after surgery was comparable between the groups (OR 0.931; 95% CI 0.357-2.426; p?=?0.884). The proximal and distal resection margins, the histologic grade of tumor, TNM stage, median tumor size, and presence of lymphovascular invasion did not differ significantly between the groups. The 5-year overall survival (OS) rates of the open and laparoscopic groups were 67.1% and 71.7% (HR 1.028, 95% CI 0.491-2.15, p?=?0.942) and the 5-year disease-free survival (DFS) rates were 55.8% and 61.5% (HR 0.982; 95% CI 0.522-1.847; p?=?0.955), respectively. The recurrence pattern did not differ between the groups. Multivariate analysis showed that sex (p?=?0.027), nodal stage (p?=?0.043), and the proportion of patients receiving postoperative adjuvant chemotherapy (p?=?0.002) were independent prognostic factors for OS. The proportion of patients receiving postoperative adjuvant chemotherapy (p?=?0.017) was an independent prognostic factor for DFS.

CONCLUSIONS: Laparoscopic resection following stent insertion for obstructing colon cancer can be performed safely, with long-term oncologic outcomes comparable with those of open surgery.
keyword
Colonic neoplasm; Laparoscopy; Outcome; Stent
링크

주제코드
주제명(Target field)
연구대상(Population)
연구참여(Sample size)
대상성별(Gender)
질병특성(Condition Category)
연구환경(Setting)
연구설계(Study Design)
연구기간(Period)
중재방법(Intervention Type)
중재명칭(Intervention Name)
키워드(Keyword)
유효성결과(Recomendation)
The 5-year overall survival (OS) rates of the open and laparoscopic groups were 67.1% and 71.7% and the 5-year disease-free survival (DFS) rates were 55.8% and 61.5%
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
출판년도(Year)
참여저자수(Authors)
대표저자
DOI
KCD코드
ICD 03
건강보험코드