Increased long-term mortality after open colorectal cancer surgery: A multicentre population-based study

Area of Science:

• Oncology
• Surgical Oncology
• Epidemiology

Background:

• Population-based studies indicate open surgery for colorectal cancer (CRC) is associated with higher short-term mortality than laparoscopic surgery.
• Long-term mortality data comparing surgical approaches for CRC remains limited.

Purpose of the Study:

• To compare long-term mortality rates between open and laparoscopic surgery in patients undergoing curative resection for colorectal cancer.

Main Methods:

• Retrospective analysis of 4531 patients from the Dutch Colorectal Audit and Dutch Cancer Centre registry (2009-2018).
• Exclusion of patients with contraindications for laparoscopic surgery (e.g., cT4/pT4 tumors, emergency surgery).
• Multivariable regression and mixed-effects Cox regression adjusted for multiple confounders to assess long-term mortality risk.

Main Results:

• Open surgery was performed in 1298 patients (29%), with a median follow-up of 43 months.
• Open surgery was significantly associated with an increased risk of long-term mortality (aHR 1.26, P=0.001).
• Further analysis confirmed an increased risk with open surgery (aHR 1.33, P=0.004).

Conclusions:

• Open surgery appears linked to higher long-term mortality in elective colorectal cancer resections.
• A minimally invasive surgical approach may lead to better long-term outcomes for colorectal cancer patients.