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Risk of Peritoneal Metastasis Following Minimally Invasive Colectomy for Locally Advanced Colon Cancer: A Systematic Review and Meta-Analysis

  • 0Department of Surgery, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH.
The Oncologist +

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July 18, 2025

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July 18, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Laparoscopic colectomy for T4 colon cancer shows a higher risk of peritoneal recurrence than open colectomy. Further research is needed to explore strategies to reduce this risk.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background

  • Locally advanced (T4) colon cancer poses a high risk for peritoneal metastasis.
  • Laparoscopic colectomy (LC) is oncologically safe, but its risk for peritoneal metastasis in T4 disease is unclear.
  • Previous reviews show similar survival for LC and open colectomy (OC), but lack direct comparison for peritoneal recurrence.

Purpose Of The Study

  • To compare the risk of peritoneal recurrence between laparoscopic colectomy (LC) and open colectomy (OC) in patients with T4 colon cancer.
  • To systematically review existing literature on peritoneal recurrence rates following LC versus OC for T4 colon cancer.

Main Methods

  • A systematic review adhering to PRISMA guidelines.
  • Included studies comparing LC and OC that reported peritoneal recurrence.
  • Calculated pooled odds ratios and hazard ratios for peritoneal recurrence using random-effects models.

Main Results

  • Nine retrospective cohort studies were included.
  • Laparoscopic colectomy was associated with a significantly increased risk of peritoneal recurrence (OR=1.61, HR=1.24).
  • Quality of evidence was low, with low to moderate risk of bias across studies.

Conclusions

  • Laparoscopic colectomy is linked to a higher risk of peritoneal recurrence in T4 colon cancer compared to open colectomy.
  • Caution is advised when using LC for cT4 colon cancer due to potential selection bias favoring LC.
  • Prospective studies should investigate strategies like neoadjuvant or adjuvant chemotherapy to mitigate peritoneal recurrence risk.

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