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Laparoscopic resection does not adversely affect early survival curves in patients undergoing surgery for colorectal
E C Poulin1, J Mamazza, C M Schlachta
1Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Objective:
To determine the survival curves for laparoscopic resection (LR) of colorectal cancer.
Summary Background Data:
Laparoscopic resection for cure of colorectal cancer is controversial, and survival curves have not been determined.
Methods:
A prospective database of 177 consecutive LRs of colorectal cancers performed between November 1991 and 1997 was reviewed. The TNM classification (stage 0, I, II, III, and IV) for colorectal cancers and the Kaplan-Meier method were used to determine survival curves.
Results:
Of the 177 patients, 5 were excluded for not having adenocarcinomas. Twenty-five patients (14.5%) had conversion to open surgery; most of these patients had rectal cancer or tumor invasion to adjacent organs. Twelve patients were lost to follow-up. All 135 remaining patients had follow-up. Overall, 28 deaths occurred during the follow-up period, 15 of which were cancer-related. The median follow-up was 24 months for patients with stage I, II, and III disease and 9 months for patients with stage IV disease. Observed 2-year survival rates were 100% stage I, 88.7% stage II, 80.6% stage III, and 28.6% stage IV. Survival rates at 4 years were 100% stage I, 79.5% stage II, 53.7% stage III, and 0% stage IV. No trocar site recurrence was observed.
Conclusions:
Early survival curves for patients with colorectal cancer who underwent LR do not differ negatively from historical controls for conventional surgery. Further validation is needed.