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Outcome after Introduction of Complete Mesocolic Excision for Colon Cancer Is Similar for Open and Laparoscopic Surgical Treatments
- Source :
- Digestive Surgery. 30:317-327
- Publication Year :
- 2013
- Publisher :
- S. Karger AG, 2013.
-
Abstract
- Background: Complete mesocolic excision (CME) and a high (apical) vascular tie may improve oncologic outcome after surgery for colon cancer. Our primary aim was to emulate a previous national result of 73.8% overall survival (OS) with both the open and laparoscopic techniques. Methods: A prospective study of radical colon cancer was initiated in a Norwegian community teaching hospital in 2007 and comprised a consecutive group of 251 patients with TNM stages I-III that had surgery according to the CME principle. Oncological outcome was assessed as OS, disease-free survival (DFS) and cancer-specific survival (CSS), as well as time to recurrence (TTR), using Cox regression analysis. Results: In-hospital mortality was 3.6%, 2.3% for laparoscopic surgery and 4.9% for open management. Significantly more patients in the open CME group developed complications in the short term (p < 0.001). Twelve or more lymph nodes were retrieved from 82.9% (208/251) of the specimens. Overall 3-year OS was 84.5%, DFS 77.4%, CSS 91.5% and TTR 86.8%. The surgical approach was not a significant predictor for any of the survival parameters. Conclusions: There was no survival difference between open and laparoscopic CME colonic resections, and the present OS improved from a previous OS from 2000.
- Subjects :
- Male
medicine.medical_specialty
Lymphatic metastasis
Colorectal cancer
education
Treatment outcome
Kaplan-Meier Estimate
Disease-Free Survival
Neoplasm Recurrence
Humans
Medicine
Hospital Mortality
Prospective Studies
Prospective cohort study
Laparoscopy
Colectomy
Aged
Neoplasm Staging
medicine.diagnostic_test
business.industry
Gastroenterology
Follow up studies
Length of Stay
medicine.disease
Surgery
Treatment Outcome
Lymphatic Metastasis
Colonic Neoplasms
Multivariate Analysis
Female
Neoplasm staging
Lymph Nodes
Neoplasm Grading
Neoplasm Recurrence, Local
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 14219883 and 02534886
- Volume :
- 30
- Database :
- OpenAIRE
- Journal :
- Digestive Surgery
- Accession number :
- edsair.doi.dedup.....f957ade161faa7fa2dc99355c25d3eb8