Laparoscopically assisted vs open colectomy for colon cancer

A meta-analysis

H. Jacob Bonjer, Wim C J Hop, Heidi Nelson, Daniel J. Sargent, Antonio M. Lacy, Antoni Castells, Pierre J. Guillou, Helen Thorpe, Julia Brown, Salvadora Delgado, Esther Kuhrij, Eva Haglind, Lars Påhlman

Research output: Contribution to journalArticle

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Abstract

Objective: To perform a meta-analysis of trials randomizing patients with colon cancer to laparoscopically assisted or open colectomy to enhance the power in determining whether laparoscopic colectomy for cancer is oncologically safe. Data Sources: The databases of the Barcelona, Clinical Outcomes of Surgical Therapy (COST), Colon Cancer Laparoscopic or Open Resection (COLOR), and Conventional vs Laparoscopic-Assisted Surgery in Patients With Colorectal Cancer (CLASICC) trials were the data sources for the study. Study Selection: Patients who had at least 3 years of complete follow-up data were selected. Data Extraction: Patients who had undergone curative surgery before March 1, 2000, were studied. Three-year disease-free survival and overall survival were the primary outcomes of this analysis. Data Synthesis: Of 1765 patients, 229 were excluded, leaving 796 patients in the laparoscopically assisted arm and 740 patients in the open arm for analysis. Three-year disease-free survival rates in the laparoscopically assisted and open arms were 75.8% and 75.3%, respectively (95% confidence interval [CI] of the difference, -5% to 4%). The associated common hazard ratio (laparoscopically assisted vs open surgery with adjustment for sex, age, and stage) was 0.99 (95% CI, 0.80-1.22; P=.92). The 3-year overall survival rate after laparoscopic surgery was 82.2% and after open surgery was 83.5% (95% CI of the difference, -3% to 5%). The associated hazard ratio was 1.07 (95% CI, 0.83-1.37; P = .61). Disease-free and overall survival rates for stages I, II, and III evaluated separately did not differ between the 2 treatments. Conclusion: Laparoscopically assisted colectomy for cancer is oncologically safe.

Original languageEnglish (US)
Pages (from-to)298-303
Number of pages6
JournalArchives of Surgery
Volume142
Issue number3
DOIs
StatePublished - Mar 2007

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Colectomy
Colonic Neoplasms
Meta-Analysis
Confidence Intervals
Disease-Free Survival
Survival Rate
Information Storage and Retrieval
Laparoscopy
Patient Selection
Colorectal Neoplasms
Neoplasms
Databases
Survival
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Bonjer, H. J., Hop, W. C. J., Nelson, H., Sargent, D. J., Lacy, A. M., Castells, A., ... Påhlman, L. (2007). Laparoscopically assisted vs open colectomy for colon cancer: A meta-analysis. Archives of Surgery, 142(3), 298-303. https://doi.org/10.1001/archsurg.142.3.298

Laparoscopically assisted vs open colectomy for colon cancer : A meta-analysis. / Bonjer, H. Jacob; Hop, Wim C J; Nelson, Heidi; Sargent, Daniel J.; Lacy, Antonio M.; Castells, Antoni; Guillou, Pierre J.; Thorpe, Helen; Brown, Julia; Delgado, Salvadora; Kuhrij, Esther; Haglind, Eva; Påhlman, Lars.

In: Archives of Surgery, Vol. 142, No. 3, 03.2007, p. 298-303.

Research output: Contribution to journalArticle

Bonjer, HJ, Hop, WCJ, Nelson, H, Sargent, DJ, Lacy, AM, Castells, A, Guillou, PJ, Thorpe, H, Brown, J, Delgado, S, Kuhrij, E, Haglind, E & Påhlman, L 2007, 'Laparoscopically assisted vs open colectomy for colon cancer: A meta-analysis', Archives of Surgery, vol. 142, no. 3, pp. 298-303. https://doi.org/10.1001/archsurg.142.3.298
Bonjer, H. Jacob ; Hop, Wim C J ; Nelson, Heidi ; Sargent, Daniel J. ; Lacy, Antonio M. ; Castells, Antoni ; Guillou, Pierre J. ; Thorpe, Helen ; Brown, Julia ; Delgado, Salvadora ; Kuhrij, Esther ; Haglind, Eva ; Påhlman, Lars. / Laparoscopically assisted vs open colectomy for colon cancer : A meta-analysis. In: Archives of Surgery. 2007 ; Vol. 142, No. 3. pp. 298-303.
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abstract = "Objective: To perform a meta-analysis of trials randomizing patients with colon cancer to laparoscopically assisted or open colectomy to enhance the power in determining whether laparoscopic colectomy for cancer is oncologically safe. Data Sources: The databases of the Barcelona, Clinical Outcomes of Surgical Therapy (COST), Colon Cancer Laparoscopic or Open Resection (COLOR), and Conventional vs Laparoscopic-Assisted Surgery in Patients With Colorectal Cancer (CLASICC) trials were the data sources for the study. Study Selection: Patients who had at least 3 years of complete follow-up data were selected. Data Extraction: Patients who had undergone curative surgery before March 1, 2000, were studied. Three-year disease-free survival and overall survival were the primary outcomes of this analysis. Data Synthesis: Of 1765 patients, 229 were excluded, leaving 796 patients in the laparoscopically assisted arm and 740 patients in the open arm for analysis. Three-year disease-free survival rates in the laparoscopically assisted and open arms were 75.8{\%} and 75.3{\%}, respectively (95{\%} confidence interval [CI] of the difference, -5{\%} to 4{\%}). The associated common hazard ratio (laparoscopically assisted vs open surgery with adjustment for sex, age, and stage) was 0.99 (95{\%} CI, 0.80-1.22; P=.92). The 3-year overall survival rate after laparoscopic surgery was 82.2{\%} and after open surgery was 83.5{\%} (95{\%} CI of the difference, -3{\%} to 5{\%}). The associated hazard ratio was 1.07 (95{\%} CI, 0.83-1.37; P = .61). Disease-free and overall survival rates for stages I, II, and III evaluated separately did not differ between the 2 treatments. Conclusion: Laparoscopically assisted colectomy for cancer is oncologically safe.",
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T1 - Laparoscopically assisted vs open colectomy for colon cancer

T2 - A meta-analysis

AU - Bonjer, H. Jacob

AU - Hop, Wim C J

AU - Nelson, Heidi

AU - Sargent, Daniel J.

AU - Lacy, Antonio M.

AU - Castells, Antoni

AU - Guillou, Pierre J.

AU - Thorpe, Helen

AU - Brown, Julia

AU - Delgado, Salvadora

AU - Kuhrij, Esther

AU - Haglind, Eva

AU - Påhlman, Lars

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N2 - Objective: To perform a meta-analysis of trials randomizing patients with colon cancer to laparoscopically assisted or open colectomy to enhance the power in determining whether laparoscopic colectomy for cancer is oncologically safe. Data Sources: The databases of the Barcelona, Clinical Outcomes of Surgical Therapy (COST), Colon Cancer Laparoscopic or Open Resection (COLOR), and Conventional vs Laparoscopic-Assisted Surgery in Patients With Colorectal Cancer (CLASICC) trials were the data sources for the study. Study Selection: Patients who had at least 3 years of complete follow-up data were selected. Data Extraction: Patients who had undergone curative surgery before March 1, 2000, were studied. Three-year disease-free survival and overall survival were the primary outcomes of this analysis. Data Synthesis: Of 1765 patients, 229 were excluded, leaving 796 patients in the laparoscopically assisted arm and 740 patients in the open arm for analysis. Three-year disease-free survival rates in the laparoscopically assisted and open arms were 75.8% and 75.3%, respectively (95% confidence interval [CI] of the difference, -5% to 4%). The associated common hazard ratio (laparoscopically assisted vs open surgery with adjustment for sex, age, and stage) was 0.99 (95% CI, 0.80-1.22; P=.92). The 3-year overall survival rate after laparoscopic surgery was 82.2% and after open surgery was 83.5% (95% CI of the difference, -3% to 5%). The associated hazard ratio was 1.07 (95% CI, 0.83-1.37; P = .61). Disease-free and overall survival rates for stages I, II, and III evaluated separately did not differ between the 2 treatments. Conclusion: Laparoscopically assisted colectomy for cancer is oncologically safe.

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