Ontology type: schema:ScholarlyArticle Open Access: True
2016-12
AUTHORSJong Seob Park, Jung Wook Huh, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Ho-Kyung Chun
ABSTRACTBACKGROUND: The role of laparoscopic resection in patients with clinically suspicious T4 colorectal cancer remains controversial. The aim of this study was to compare the long-term and oncologic outcomes of laparoscopic resection and the open approach in clinical T4 colorectal cancer. METHODS: Two hundred ninety-three consecutive patients undergoing curative surgery for colorectal cancer suspected to be T4 by computed tomography and/or magnetic resonance imaging were reviewed. RESULTS: Despite clinical suspicion of T4 disease in all cases, concordance with pathologic determination of T4 was only 37.9 %. Of the 71 patients in the laparoscopic group, four (5.6 %) were converted to the open technique. Patients in the laparoscopic group had significantly lower estimated blood loss (p < 0.001), fewer days to first flatus (p = 0.001), shorter length of hospital stay (p < 0.001), and fewer adverse events (14.1 % versus 31.5 %, p = 0.004). After a median follow-up of 36 months, 5-year disease-free survival was not significantly different between the two groups (81.8 % in laparoscopic versus 73.9 % in open surgery, p = 0.433). The clinical factors that predicted T4 staging on pathologic examination were found to be male sex (p = 0.038), preoperative carcinoembryonic antigen status (p = 0.021), clinical N status (p = 0.046), and clinical cancer perforation (p = 0.004). CONCLUSIONS: Laparoscopic colorectal resection for T4 colorectal cancer has perioperative and long-term oncologic outcomes similar to those of the open approach when performed by an experienced surgeon. More... »
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"description": "BACKGROUND: The role of laparoscopic resection in patients with clinically suspicious T4 colorectal cancer remains controversial. The aim of this study was to compare the long-term and oncologic outcomes of laparoscopic resection and the open approach in clinical T4 colorectal cancer.\nMETHODS: Two hundred ninety-three consecutive patients undergoing curative surgery for colorectal cancer suspected to be T4 by computed tomography and/or magnetic resonance imaging were reviewed.\nRESULTS: Despite clinical suspicion of T4 disease in all cases, concordance with pathologic determination of T4 was only 37.9\u00a0%. Of the 71 patients in the laparoscopic group, four (5.6\u00a0%) were converted to the open technique. Patients in the laparoscopic group had significantly lower estimated blood loss (p\u2009<\u20090.001), fewer days to first flatus (p\u2009=\u20090.001), shorter length of hospital stay (p\u2009<\u20090.001), and fewer adverse events (14.1\u00a0% versus 31.5\u00a0%, p\u2009=\u20090.004). After a median follow-up of 36\u00a0months, 5-year disease-free survival was not significantly different between the two groups (81.8\u00a0% in laparoscopic versus 73.9\u00a0% in open surgery, p\u2009=\u20090.433). The clinical factors that predicted T4 staging on pathologic examination were found to be male sex (p\u2009=\u20090.038), preoperative carcinoembryonic antigen status (p\u2009=\u20090.021), clinical N status (p\u2009=\u20090.046), and clinical cancer perforation (p\u2009=\u20090.004).\nCONCLUSIONS: Laparoscopic colorectal resection for T4 colorectal cancer has perioperative and long-term oncologic outcomes similar to those of the open approach when performed by an experienced surgeon.",
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