Laparoscopic Colorectal Cancer Resection in High-Volume Surgical Centers: Long-Term Outcomes from the LAPCOLON Group Trial

Background Strong evidence has confirmed the benefit of laparoscopy in colorectal cancer resection but remains a challenging procedure. It is not clear that such promising results in selected patients translate into a favorable risk–benefit balance in real practice. We conducted a multicenter nation...

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Bibliographic Details
Published in:World journal of surgery 2015-08, Vol.39 (8), p.2045-2051
Main Authors: Huscher, Cristiano G. S., Bretagnol, Frederic, Corcione, Francesco
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Anastomotic Leak - epidemiology
Cancer Recurrence Rate
Cardiac Surgery
Colectomy - methods
Colonic Neoplasms - surgery
Colorectal Neoplasms - surgery
Colorectal Resection
Conversion to Open Surgery - statistics & numerical data
Disease-Free Survival
Female
General Surgery
Hospitals, High-Volume
Humans
Italy - epidemiology
Laparoscopic Colorectal Resection
Laparoscopy - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Neoplasm Recurrence, Local
Original Scientific Report
Postoperative Complications
Prospective Studies
Rectal Cancer
Rectal Neoplasms - surgery
Registries
Surgery
Thoracic Surgery
Time Factors
Total Mesorectal Excision
Treatment Outcome
Vascular Surgery
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Summary:Background Strong evidence has confirmed the benefit of laparoscopy in colorectal cancer resection but remains a challenging procedure. It is not clear that such promising results in selected patients translate into a favorable risk–benefit balance in real practice. We conducted a multicenter national observational registry to assess operative and oncologic long-term outcomes following laparoscopic colorectal cancer resection. Methods All patients with laparoscopic colorectal cancer resection between 2001 and 2004 were included. Data were extracted from the prospective Italian national database of 10 high-volume centers (≥40 colorectal cancer laparoscopic resections per year). Surgical technique and follow-up were standardized. Survivals were analyzed by Kaplan–Meier method. Results We reported 1832 patients with colon (58.5 %) and rectal cancer (41.5 %). TNM stage was 0–I–II in 1044 patients (57 %) and III–IV in 788 patients (43 %). Surgery included a totally laparoscopic procedure in 1820 patients (99.3 %). Conversion was 10.5 %. Postoperative morbidity and 30-day mortality rates were 17 and 1.2 %, respectively. Clinical anastomotic leakage rate was 8.3 % ( n  = 152). R0 resection was 95 %. With a median follow-up of 54.2 months, cancer recurrence rate was 13.3 %. At 5 years, cancer-free survival was 86.7 %. Upon multivariate analysis, age ( P  = 0.001) and TNM stage ( P  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-015-3050-4