Premium
Comparison of open and minimally invasive approaches to colon cancer resection in compliance with 12 regional lymph node harvest quality measure
Author(s) -
Williams Austin D.,
Sun Tian,
Kakade Sumedh,
Wong Sandra L.,
Shulman Lawrence N.,
Carp Ned Z.
Publication year - 2021
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.26298
Subject(s) - medicine , colorectal cancer , lymph node , cancer , benchmark (surveying) , stage (stratigraphy) , surgery , pathological , colectomy , lymph , t stage , lymphovascular invasion , multivariate analysis , metastasis , pathology , paleontology , geodesy , biology , geography
Background There has been a growing trend toward minimally invasive surgery (MIS) for colon cancer. Pathological analysis of a minimum of 12 lymph nodes (LNs) is a benchmark for adequate resection. Here, we present a comparison of surgical techniques in achieving a full oncologic resection. Methods Patients undergoing surgery for Stage I–III colon cancer (2010–2016) were identified from the National Cancer Database. Cases were stratified by surgical approach. Trends in approach were assessed, including whether the 12‐LN benchmark was met. Uni‐ and multivariate regression was used to assess overall survival (OS). Results A total of 290,776 colectomies were analyzed. MIS increased from 32.8% to 57.2% from 2010 to 2016 ( p < .001). An overall median of 18 LNs were harvested and compliance with the 12‐LN benchmark increased (84.6%–91.6%, p < .001); there were no difference between open and MIS. A subset analysis comparing hospital type revealed that regardless of approach, compliance was lower at community hospitals ( p < .001). OS was better for patients treated at academic or National Cancer Institute centers, underwent MIS, and in those meeting the 12‐LN benchmark (all p ≤ .002). Conclusion As MIS colon resections continue to increase, we demonstrate that there is no difference in the ability to achieve the 12‐LN benchmark with open and MIS approaches.