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 journalReview article

412 Scopus citations

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

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Laparoscopically assisted vs open colectomy for colon cancer: A meta-analysis'. Together they form a unique fingerprint.

  • Cite this

    Bonjer, H. J., Hop, W. C. J., Nelson, H., Sargent, D. J., Lacy, A. M., Castells, A., Guillou, P. J., 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, 142(3), 298-303. https://doi.org/10.1001/archsurg.142.3.298