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Impact of laparoscopic surgery on the long‐term outcomes for patients with rectal cancer
Author(s) -
Kim JunGi,
Heo YounJung,
Son GyungMo,
Lee YoonSuk,
Lee InKyu,
Suh YoungJin,
Cho HyeonMin,
Chun ChungSoo
Publication year - 2009
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2009.05109.x
Subject(s) - medicine , laparoscopic surgery , hazard ratio , surgery , colorectal cancer , proportional hazards model , laparoscopy , retrospective cohort study , cancer , stage (stratigraphy) , confidence interval , multivariate analysis , paleontology , biology
Background: This 20‐year retrospective study compared the results of laparoscopic surgery with open surgery for patients with rectal cancer to evaluate the impact of laparoscopic surgery on long‐term oncological outcomes for rectal cancer. Methods: We analysed survival data collected over 20 years for patients with rectal cancer ( n = 407) according to surgical methods and tumour stage between those treated with laparoscopic surgery ( n = 272) and those with open surgery ( n = 135). Clinical factors were analysed to ascertain possible risk factors that might have been associated with survival from and recurrence of rectal cancer. A multivariate analysis was applied by using Cox's regression model to determine the impact of laparoscopic surgery on long‐term oncological outcomes. Results: Overall survival, disease‐specific survival and disease‐free survival rates were statistically higher in the laparoscopic group than in the open‐surgery group. The incidence of local recurrence in the laparoscopic group (7.9%; 95% confidence intervals (CI), 4.2–11.5) was significantly lower than that for the open‐surgery group (30.2%; 95% CI, 21.0–39.3; P < 0.001). By using a multivariate analysis, laparoscopic surgery for rectal cancer appeared not to be an independent factor for disease‐specific survival or disease‐free survival. However, the laparoscopic surgery was an independent factor associated with reduced local recurrence (Hazard ratio (HR), 3.408; 95% CI, 1.890–6.149; P < 0.001). Conclusion: Laparoscopic surgery did not adversely affect the long‐term oncological outcome for patients with rectal cancer.