Title
Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer
Author
Deijen, Charlotte L. (Amsterdam UMC)
Vasmel, Jeanine E. (Amsterdam UMC)
de Lange-de Klerk, Elly S M (Amsterdam UMC)
Cuesta, Miguel A. (Amsterdam UMC)
Coene, Peter Paul L O (Maasstad Hospital)
Lange, Johan F. (Erasmus MC)
Meijerink, W. J H Jeroen (Amsterdam UMC)
Jakimowicz, J.J. (TU Delft Applied Ergonomics and Design)
Jeekel, Johannes (Erasmus MC)
Kazemier, Geert (Amsterdam UMC)
Janssen, Ignace M C (Rijnstate Hospital)
Påhlman, Lars (Uppsala University Hospital)
Haglind, Eva (Sahlgrenska University Hospital/Östra)
Bonjer, H. Jaap (Amsterdam UMC)
Date
2016
Abstract
Background: Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up. Methods: Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842). Results: In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) −10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI −10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI −11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n = 3 vs. open n = 4). Conclusions: Laparoscopic surgery for non-metastatic colon cancer is associated with similar rates of disease-free survival, overall survival and recurrences as open surgery at 10-year follow-up.
Subject
Colon cancer
Laparoscopic
Randomised clinical trial
Surgery
Treatment
To reference this document use:
http://resolver.tudelft.nl/uuid:e96f5992-cc16-44ec-a3db-d1b6cbd669d8
DOI
https://doi.org/10.1007/s00464-016-5270-6
ISSN
0930-2794
Source
Surgical Endoscopy: surgical and interventional techniques (online), 31 (6), 2607-2615
Part of collection
Institutional Repository
Document type
journal article
Rights
© 2016 Charlotte L. Deijen, Jeanine E. Vasmel, Elly S M de Lange-de Klerk, Miguel A. Cuesta, Peter Paul L O Coene, Johan F. Lange, W. J H Jeroen Meijerink, J.J. Jakimowicz, Johannes Jeekel, Geert Kazemier, Ignace M C Janssen, Lars Påhlman, Eva Haglind, H. Jaap Bonjer