Annals of Surgery

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Annals of Surgery:
doi: 10.1097/SLA.0b013e31816a9d65

The Long-term Results of a Randomized Clinical Trial of Laparoscopy-assisted Versus Open Surgery for Colon Cancer

Lacy, Antonio M. MD, PhD*; Delgado, Salvadora MD, PhD*; Castells, Antoni MD, PhD†; Prins, Hubert A. MD, PhD*; Arroyo, Vicente MD, PhD†; Ibarzabal, Ainitze MD, PhD*; Pique, Josep M. MD, PhD†

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Objective: The aim of this study was to compare the long-term outcome of laparoscopy-assisted colectomy (LAC) and open colectomy (OC) for nonmetastatic colon cancer.

Methods: From November 1993 to July 1998 all patients with adenocarcinoma of the colon were assessed for entry in this single center, clinically randomized trial. Adjuvant therapy and postoperative follow-up were similar in both groups. The primary endpoint was cancer-related survival and secondary endpoints were probability of overall survival and probability of being free of recurrence. Data were analyzed according the intention-to-treat principle.

Results: Two hundred and nineteen patients entered the study (111 LAC group and 108 OC group). The median follow-up was 95 months (range, 77–133). There was a tendency of higher cancer-related survival (P = 0.07, NS) and overall survival (P = 0.06, NS) for the LAC group. Probability of cancer-related survival was higher in the LAC group (P = 0.02) when compared with OC. The regression analysis showed that LAC was independently associated with a reduced risk of tumor relapse (hazard ratio 0.47, 95% CI 0.23–0.94), death from a cancer-related cause (0.44, 0.21–0.92) and death from any cause (0.59, 0.35–0.98).

Conclusions: LAC is more effective than OC in the treatment of colon cancer.

© 2008 Lippincott Williams & Wilkins, Inc.


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