Long-term oncological outcomes in patients undergoing laparoscopic versus open surgery for colon cancer: A nationwide cohort study

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Aim To estimate the effect of laparoscopy versus laparotomy on recurrence status in patients undergoing intended curative resection for stage I-III colon cancer using nationwide data. Method A retrospective cohort study using prospectively collected nationwide quality assurance data on all patients undergoing elective, intended curative surgery for UICC stage I-III colon cancer in Denmark from 1 January 2010, through 31 December 2013. The association between laparoscopic versus open surgery and recurrence status was investigated using cause-specific hazard and subdistribution hazard models with death from any cause as a competing event. Results In total, 4369 patients undergoing elective intended curative surgery for colon cancer were included in the analysis. Overall, 3243 (74.2%) patients underwent laparoscopic surgery. During a median follow-up time of 84 months, 1191 (27.2%) patients experienced recurrence, and 1304 (29.8%) patients died. The cause-specific hazard of recurrence following laparoscopic versus open surgery was HRCS = 1.08, 95% CI: 0.90-1.28, p = 0.422. The subdistribution hazard of recurrence following laparoscopic versus open surgery was HRSD=0.99, 95% CI: 0.84-1.16, p = 0.880. Conclusion Elective laparoscopic resection for UICC stage I-III colon cancer is oncologically safe and comparable with open resection. These results confirm the external validity of previous RCTs in everyday clinical settings.

Original languageEnglish
JournalColorectal Disease
Volume24
Issue number4
Pages (from-to)439-448
ISSN1462-8910
DOIs
Publication statusPublished - 2022

    Research areas

  • colon cancer, minimally invasive surgery, Oncological surgery, RANDOMIZED CLINICAL-TRIAL, MRC CLASICC TRIAL, COLORECTAL-CANCER, OPEN COLECTOMY, FOLLOW-UP, METAANALYSIS, SURVIVAL, REGISTRY, HAZARDS

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