Comparison of a five-year survival and cancer recurrence between laparoscopically assisted and open colonic resections due to adenocarcinoma : a single centre experience

Janež, Jurij (author), Škapin, Armand Dominik (author)

Background and objectives: When resecting colon adenocarcinoma, surgeons decide between the use of laparoscopically assisted and open surgery. Laparoscopic resection is known to have short-term benefits over an open operation. However, researchers are not as unified about the long-term findings. The aim of this research is to elaborate on five-year post-operative differences in survival and cancer recurrence between these two different approaches. Materials and methods: 74 enrolled patients were evaluated five years after a primary operation. We collected dates of deaths of deceased patients and time after operation of possible recurrences. Carcinoma staging was done by a pathologist after operation. Blood samples were taken before surgery in order to measure tumor markers (CA19-9 and CEA). Results: Survival after colonic adenocarcinoma surgery did not differ between the two different surgical approaches (p = 0.151). Recurrence of cancer was not associated with the type of operation (p = 0.532). Patients with recurrence had a 37.6 times greater hazard ratio of dying (95% CI: [12.0, 118]; p < 0.001). Advanced age adversely affected survival: patients aged < 0.001). Patients with different TNM stages did not have any statistically significant differences in survival (HR$_{II}$ = 2.49; 95% CI: [0.67, 9.30]; p$_{II}$ = 0.173) (HR$_{III}$ = 2.18; 95% CI: [0.58, 8.12]; p$_{III}$ = 0.246) or recurrence (p = 0.097). Conclusion: The obtained results suggest that laparoscopic resection of colon cancer is not inferior from an oncologic point of view and results in a similar long-term survival and disease-free interval. Recurrence of carcinoma, older age at initial operation and elevated tumor markers, above a pre-set threshold at operation, were found to be independent factors of lower survival. We believe that the obtained results will be of benefit when choosing treatment for colon adenocarcinoma.

• Language: English
• Keywords: colon cancer, survival, recurrence, surgery, laparoscopy
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2020
• Number of pages: 11 str.
• Numbering: Vol. 56, iss. 2, art. 93
• PID: 20.500.12556/RUL-133430
• UDC: 617
• ISSN on article: 1648-9144
• DOI: 10.3390/medicina56020093
• COBISS.SI-ID: 7045036
• Publication date in RUL: 26.11.2021

Record is a part of a journal

• Title: Medicina
• Publisher: MDPI
• ISSN: 1648-9144
• COBISS.SI-ID: 6754623

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.
• Licensing start date: 24.02.2020