Impact of laparoscopic surgery on the long-term outcomes for patients with rectal cancer.
BACKGROUND
This 20-year retrospective study compared the results of laparoscopic surgery with open surgery for patients with rectal cancer to evaluate the impact of laparoscopic surgery on long-term oncological outcomes for rectal cancer.


METHODS
We analysed survival data collected over 20 years for patients with rectal cancer (n= 407) according to surgical methods and tumour stage between those treated with laparoscopic surgery (n= 272) and those with open surgery (n= 135). Clinical factors were analysed to ascertain possible risk factors that might have been associated with survival from and recurrence of rectal cancer. A multivariate analysis was applied by using Cox's regression model to determine the impact of laparoscopic surgery on long-term oncological outcomes.


RESULTS
Overall survival, disease-specific survival and disease-free survival rates were statistically higher in the laparoscopic group than in the open-surgery group. The incidence of local recurrence in the laparoscopic group (7.9%; 95% confidence intervals (CI), 4.2-11.5) was significantly lower than that for the open-surgery group (30.2%; 95% CI, 21.0-39.3; P < 0.001). By using a multivariate analysis, laparoscopic surgery for rectal cancer appeared not to be an independent factor for disease-specific survival or disease-free survival. However, the laparoscopic surgery was an independent factor associated with reduced local recurrence (Hazard ratio (HR), 3.408; 95% CI, 1.890-6.149; P < 0.001).


CONCLUSIONS
Laparoscopic surgery did not adversely affect the long-term oncological outcome for patients with rectal cancer.
Kim
Jun-Gi
JG
Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea, Suwon, Korea. jgkim@catholic.ac.kr
Heo
Youn-Jung
YJ
Son
Gyung-Mo
GM
Lee
Yoon-Suk
YS
Lee
In-Kyu
IK
Suh
Young-Jin
YJ
Cho
Hyeon-Min
HM
Chun
Chung-Soo
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012004:Rectal Neoplasms / Q000401:mortality* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome