TY - JOUR
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
PY - 2007/3
Y1 - 2007/3
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.
AB - 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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U2 - 10.1001/archsurg.142.3.298
DO - 10.1001/archsurg.142.3.298
M3 - Review article
C2 - 17372057
AN - SCOPUS:33947392987
SN - 0004-0010
VL - 142
SP - 298
EP - 303
JO - Archives of Surgery
JF - Archives of Surgery
IS - 3
ER -