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  1. Home
  3. Laparoscopic Versus Open Colectomy For Locally Advanced Colon Cancer In Obese Patients: A Nationwide, Multicenter, Propensity Score-based Analysis Of Short- And Long-term Outcomes.
  1. Home
  3. Laparoscopic Versus Open Colectomy For Locally Advanced Colon Cancer In Obese Patients: A Nationwide, Multicenter, Propensity Score-based Analysis Of Short- And Long-term Outcomes.

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Laparoscopic versus open colectomy for locally advanced colon cancer in obese patients: a nationwide, multicenter,

Kentaro Nakajima1, Tomonori Akagi2, Yohei Kono2

  • 1Department of Surgery, NTT Medical Center Tokyo, Tokyo, Japan.

Japanese Journal of Clinical Oncology
|September 22, 2024

View abstract on PubMed

Summary
This summary is machine-generated.
Keywords:
body mass indexcolonic neoplasmlaparoscopy

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Laparoscopic colectomy is non-inferior to open surgery for obese patients with colon cancer, showing similar long-term outcomes. This minimally invasive approach offers improved short-term benefits like reduced blood loss and shorter hospital stays.

Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Obesity presents challenges in surgical treatment for locally advanced colon cancer.
  • Evaluating the efficacy of laparoscopic colectomy versus open surgery in this patient group is crucial.

Purpose of the Study:

  • To compare short- and long-term outcomes of laparoscopic colectomy and open surgery in obese patients with locally advanced colon cancer.
  • To determine the non-inferiority of laparoscopic surgery to open surgery in this population.

Main Methods:

  • Retrospective review of prospectively collected data from a large cohort (UMIN-ID: UMIN000033529) of obese patients (BMI ≥25 kg/m2).
  • Patients underwent laparoscopic or open surgery for pathological stage II-III colon cancer between 2009 and 2013.
  • Propensity score matching was used for comparative analysis, with 3-year relapse-free survival (RFS) as the primary endpoint.

    • Main Results:

    • Propensity score matching created comparable groups of 526 patients each for laparoscopic and open surgery.
    • Laparoscopic surgery demonstrated significantly less estimated blood loss (20 vs. 140 ml) and shorter hospital stays (10 vs. 12 days).
    • Similar lymph node retrieval, complication rates, and 3-year RFS rates (82.8% vs. 81.2%) were observed, confirming non-inferiority (one-sided P = .001).

    Conclusions:

    • Laparoscopic colectomy is a safe and effective alternative to open surgery for obese patients with locally advanced colon cancer.
    • The procedure offers significant short-term advantages without compromising long-term oncological outcomes.
    • This supports the use of minimally invasive approaches in managing colon cancer in obese individuals.