Short-term and oncological outcomes in laparoscopic colectomy in colon cancer stage I-III with 3-year follow-up

Cir Cir. 2020;88(3):314-320. doi: 10.24875/CIRU.19001353.

Abstract
in English, Spanish

Background: Laparoscopic colectomy (LC) presents similar short-term results and oncological outcomes to conventional colectomy (CC) in colon cancer.

Objectives: Compare short-term and oncological outcomes at 3-year follow up between LC and CC.

Materials and methods: Patients who underwent LC and CC for colon cancer between January 2010 and December 2017 were retrospectively analyzed. Short-term results and oncological outcomes were studied.

Results: Two hundred sixty-nine patients were included in the study. CC was performed in 37.5% and LC in 62.5%. LC presented shorter operative time (157 vs. 175 min, p = 0.01), shorter length of stay (8.4 vs. 10.5 days, p = 0.02), lees readmission (6% vs. 15%, p = 0.02), and lower morbidity (40% vs. 56%, p = 0.01). No differences were found for overall survival (OAS) (LC = 87.1% vs. CC = 82.8%, p = 0.28) and disease-free survival (DFS) (LC = 78.2% vs. CC = 75.3%, p = 0.47). Recurrence was observed in 37 patients (LC = 16.1% vs. CC = 18.3%, p = 0.53). No differences were found for local recurrence (LC = 6.5% vs. CC = 8.6%, p = 0.49) and distant recurrence (LC = 12.1% vs. CC = 16.1%, p = 0.3). Stage analysis showed no difference for recurrence, OAS, and DFS.

Conclusions: LC is a safe procedure with short-term outcomes, OAS, DFS, and recurrence similar to CC. LC should be the initial indication in non-metastatic colon cancer in our population.

Antecedentes: La colectomía laparoscópica (CL) presenta resultados a corto plazo y oncológicos similares a los de la colectomía convencional (CC) en cáncer de colon.

Objetivo: Comparar los resultados a corto plazo y oncológicos a 3 años de seguimiento entre la CL y la CC.

Material y métodos: Pacientes intervenidos de CL y CC por cáncer de colon entre enero de 2010 y diciembre de 2017. Se estudiaron los resultados a corto plazo y oncológicos.

Resultados: Se incluyeron 269 pacientes (62.5% CL y 37.5% CC). La CL presentó menor tiempo quirúrgico (157 vs. 175 min; p = 0.01), menor estadía hospitalaria (8.4 vs. 10.5 días; p = 0.02), menor reinternación (6% vs. 15%; p = 0.02) y menor morbilidad (40 vs. 56%; p = 0.01). No se observan diferencias para sobrevida global (87.1% CL y 82.8% CC; p = 0.28) y sobrevida libre de enfermedad (78.2% CL y 75.3% CC; p = 0.47). Hubo recidiva en 37 pacientes (16.1% CL y 18.3% CC; p = 0.53). No se encontraron diferencias en recidiva local (6.5% CL y 8.6% CC; p = 0.49), a distancia (12.1% CL y 16.1% CC; p = 0.3), al dividir la recidiva, la sobrevida global y la sobrevida libre de enfermedad por estadios.

Conclusiones: La CL es un procedimiento seguro, con una sobrevida global, una sobrevida libre de enfermedad y una tasa de recidiva similares a las de la CC. La CL debería ser la indicación inicial en el cáncer de colon no metastásico en nuestra población.

Keywords: Análisis de supervivencia; Colectomy; Colectomía; Colonic neoplasms; Laparoscopy; Laparoscopía; Morbidity; Morbilidad; Neoplasia colónica; Survival analysis.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Colectomy / methods*
  • Colectomy / statistics & numerical data
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy / methods*
  • Laparoscopy / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Lymph Node Excision / statistics & numerical data
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Operative Time
  • Patient Readmission / statistics & numerical data
  • Postoperative Complications / epidemiology
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome