Conversion to open from laparoscopic colon resection is a marker for worse oncologic outcomes in colon cancer

Leonardo de Castro Duraes; Scott R Steele; Mariane Gouvêa Monteiro de Camargo; Emre Gorgun; Matthew F Kalady; Michael Valente; Anuradha Bhama; Conor Patrick Delaney

doi:10.1016/j.amjsurg.2018.10.042

Conversion to open from laparoscopic colon resection is a marker for worse oncologic outcomes in colon cancer

Am J Surg. 2019 Mar;217(3):491-495. doi: 10.1016/j.amjsurg.2018.10.042. Epub 2018 Oct 31.

Authors

Leonardo de Castro Duraes¹, Scott R Steele², Mariane Gouvêa Monteiro de Camargo³, Emre Gorgun⁴, Matthew F Kalady⁵, Michael Valente⁶, Anuradha Bhama⁷, Conor Patrick Delaney⁸

Affiliations

¹ Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: duraesl@ccf.org.
² Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: steeles3@ccf.org.
³ Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: camargm@ccf.org.
⁴ Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: gorgune@ccf.org.
⁵ Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: kaladym@ccf.org.
⁶ Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: valentm2@ccf.org.
⁷ Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: bhamaa@ccf.org.
⁸ Department of Colorectal Surgery, Cleveland Clinic Foundation, Crile Building, 2049 East 100th Street, Cleveland, OH, 44195, USA. Electronic address: delanec@ccf.org.

PMID: 30392676
DOI: 10.1016/j.amjsurg.2018.10.042

Abstract

Background: This study aimed to evaluate the oncological outcomes of conversion in patients undergoing resection for colon cancer.

Methods: Patients with stages I-III colon adenocarcinoma operated on between 2000 and 2012 were included. Oncologic outcomes were assessed by surgical approach (laparoscopy vs. open). A secondary analysis compared patients who required conversion to open vs. laparoscopic only.

Results: We identified 1196 patients that met inclusion criteria (28% laparoscopic, 72% open). Overall, 13% of laparoscopic cases were converted to open. There were no differences in 5-year overall survival (OS) (p = 0.258), disease-free survival, (DFS) (p = 0.070), cancer-specific survival (CSS) (p = 0.207), or recurrence (p = 0.216) between laparoscopy and open surgery. However, patients with conversion had a worse OS (p = 0.010) and DFS (p = 0.006) when compared to laparoscopic only.

Conclusion: Conversion from laparoscopic to open surgery is a marker for worse survival outcomes. Further investigation is needed to define the underlying cause of these differences.

MeSH terms

Adenocarcinoma / pathology
Adenocarcinoma / surgery*
Aged
Colectomy / methods*
Colonic Neoplasms / pathology
Colonic Neoplasms / surgery*
Conversion to Open Surgery / adverse effects*
Female
Humans
Male
Neoplasm Grading
Neoplasm Staging
Survival Rate