Minimally invasive, laparoscopically assisted colectomy for colon cancer was first considered in 1990. This prompted a trial evaluation.
In this study, the Clinical Outcomes of Surgical Therapy Study Group conducted a noninferiority trial at 48 institutions.
A total of 872 patients with adenocarcinoma of the colon were randomized to undergo open or laparoscopically assisted colectomy.
The median follow-up was 4.4 years.
The primary end point was the time to tumor recurrence.
|Recurrence was similar between the 2 groups.|
|New England Journal of Medicine|
The team found that the rates of recurrence after 3 years were similar in the 2 groups.
They determined that recurrence occurred in 16% of the laparoscopic group and 18% of the open group.
In addition, recurrence rates in surgical wounds were less than 1% for both groups.
The team found that the overall survival rate was also very similar between the 2 groups.
There was no significant difference in the time to recurrence or overall survival for patients with any stage of cancer.
They established that perioperative recovery was faster in the laparoscopic-surgery group than in the open-colectomy group. This was reflected by a shorter median hospital stay, as well as briefer use of parenteral narcotics and oral analgesics.
The Clinical Outcomes of Surgical Therapy Study Group concluded, "Rates of recurrent cancer were similar after laparoscopically assisted colectomy and open colectomy".
This suggests, "That the laparoscopic approach is an acceptable alternative to open surgery for colon cancer".