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Comparing oncological outcomes of laparoscopic versus open surgery for colon cancer: Analysis of a large prospective clinical database
Author(s) -
Sammour T.,
Jones Ian T.,
Gibbs P.,
Chandra R.,
Steel Malcolm C.,
Shedda Susan M.,
Croxford M.,
Faragher I.,
Hayes Ian P.,
Hastie Ian A.
Publication year - 2015
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23893
Subject(s) - medicine , colorectal cancer , laparoscopic surgery , proportional hazards model , prospective cohort study , confounding , cancer , clinical trial , surgery , randomized controlled trial , laparoscopy
Background Oncological outcomes of laparoscopic colon cancer surgery have been shown to be equivalent to those of open surgery, but only in the setting of randomized controlled trials on highly selected patients. The aim of this study is to investigate whether this finding is generalizable to real world practice. Methods Analysis of prospectively collected data from the BioGrid Australia database was undertaken. Overall and cancer specific survival rates were compared with cox regression analysis controlling for the confounders of age, sex, BMI, ASA score, hospital site, year surgery performed, procedure, tumor stage, and adjuvant chemotherapy. Results Between 2003 and 2009, 1,106 patients underwent elective colon cancer resection. There were differences between the laparoscopic and open cohorts in BMI, procedure, post‐operative complication rate, and tumor stage. When baseline confounders were accounted for using cox regression analysis, there was no difference in 5 year overall survival (χ 2 test 1.302, P = 0.254), or cancer specific survival (χ 2 test 0.028, P = 0.866). Conclusion This large prospective clinical study validates previous trial results, and confirms that there is no difference in oncological outcome between laparoscopic and open surgery for colon cancer. J. Surg. Oncol. 2015 111:891–898 . © 2014 Wiley Periodicals, Inc.