OBJECTIVE: The aim of this study was to compare the long-term outcome of laparoscopy-assisted colectomy (LAC) and open colectomy (OC) for nonmetastatic colon cancer. METHODS:From November 1993 to July 1998 all patients with adenocarcinoma of the colon were assessed for entry in this single center, clinically randomized trial. Adjuvant therapy and postoperative follow-up were similar in both groups. The primary endpoint was cancer-related survival and secondary endpoints were probability of overall survival and probability of being free of recurrence. Data were analyzed according the intention-to-treat principle. RESULTS:Two hundred and nineteen patients entered the study (111 LAC group and 108 OC group). The median follow-up was 95 months (range, 77-133). There was a tendency of higher cancer-related survival (P = 0.07, NS) and overall survival (P = 0.06, NS) for the LAC group. Probability of cancer-related survival was higher in the LAC group (P = 0.02) when compared with OC. The regression analysis showed that LAC was independently associated with a reduced risk of tumor relapse (hazard ratio 0.47, 95% CI 0.23-0.94), death from a cancer-related cause (0.44, 0.21-0.92) and death from any cause (0.59, 0.35-0.98). CONCLUSIONS:LAC is more effective than OC in the treatment of colon cancer.
RCT Entities:
OBJECTIVE: The aim of this study was to compare the long-term outcome of laparoscopy-assisted colectomy (LAC) and open colectomy (OC) for nonmetastatic colon cancer. METHODS: From November 1993 to July 1998 all patients with adenocarcinoma of the colon were assessed for entry in this single center, clinically randomized trial. Adjuvant therapy and postoperative follow-up were similar in both groups. The primary endpoint was cancer-related survival and secondary endpoints were probability of overall survival and probability of being free of recurrence. Data were analyzed according the intention-to-treat principle. RESULTS: Two hundred and nineteen patients entered the study (111 LAC group and 108 OC group). The median follow-up was 95 months (range, 77-133). There was a tendency of higher cancer-related survival (P = 0.07, NS) and overall survival (P = 0.06, NS) for the LAC group. Probability of cancer-related survival was higher in the LAC group (P = 0.02) when compared with OC. The regression analysis showed that LAC was independently associated with a reduced risk of tumor relapse (hazard ratio 0.47, 95% CI 0.23-0.94), death from a cancer-related cause (0.44, 0.21-0.92) and death from any cause (0.59, 0.35-0.98). CONCLUSIONS: LAC is more effective than OC in the treatment of colon cancer.
Authors: Dara O Kavanagh; David Gibson; Diarmaid C Moran; Myles Smith; Kate O Donnell; Emmanuel Eguare; Frank B V Keane; Diarmaid S O Riordain; Paul C Neary Journal: Int J Colorectal Dis Date: 2010-10-23 Impact factor: 2.571
Authors: Josep Martí; Josep Fuster; Anna M Solà; Georgina Hotter; Rafael Molina; Amalia Pelegrina; Joana Ferrer; Ramon Deulofeu; Constantino Fondevila; Juan Carlos García-Valdecasas Journal: World J Surg Date: 2013-05 Impact factor: 3.352
Authors: S Ishihara; T Watanabe; Y Fukushima; T Akahane; A Horiuchi; R Shimada; K Nakamura; T Hayama; H Yamada; K Nozawa; K Matsuda; Y Hashiguchi Journal: Tech Coloproctol Date: 2013-09-17 Impact factor: 3.781