Comparison of immunologic outcomes of laparoscopic vs open approaches in clinical stage III colorectal cancer.
OBJECTIVE
Improved survival in patients with stage III colon cancer after a laparoscopic colectomy (LC) has been reported by Lacy et al. (Lancet 359:2224-2229, 6), and preserved immunity was suggested as the reason for the survival advantage. The aim of our study was to clarify the existence of an immunological benefit after laparoscopic colon cancer surgery (LC) compared to open colon surgery (OC).


METHODS
From January 2006 to November 2007, 74 patients with clinical stage III colon cancer were prospectively assigned to undergo a LC (n = 35) or an OC (n = 39). The immune factors were examined preoperatively, and on the first and fifth days postoperatively (POD1 and POD5).


RESULTS
The cellular immune factors were significantly decreased; however, there was no significant difference between the LC and OC groups except for the mHLA-DR. The LC group had a better preserved mHLA-DR on POD5 than did the OC group (p = 0.015), in addition to a faster recovery (p < 0.005).


CONCLUSIONS
The mHLA-DR on POD5 was affected less by the LC compared to the OC. The LC demonstrated minimal immunological advantage when compared to the OC. However, further study is required to clarify the immunological benefits of the LC on colorectal cancer prognosis.
Han
Sang-Ah
SA
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-dong #50, Gangnam-gu, Seoul, Korea, 135-710.
Lee
Woo Yong
WY
Park
Chi-Min
CM
Yun
Seong Hyeon
SH
Chun
Ho-Kyung
HK
D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000276:immunology* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006684:HLA-DR Antigens / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular / Q000276:immunology; D010535:Laparoscopy; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016896:Treatment Outcome
D006684:HLA-DR Antigens; D002097:C-Reactive Protein