Comparison of short, long-term surgical outcomes and mid-term health-related quality of life after laparoscopic and open resection for colorectal cancer: a case-matched control study.
BACKGROUND
A multicenter randomized study is high quality, but it is also true that there are differences between institutions. The quality of treatment is consistent in a single center so comparisons in a retrospective study can be matched for many variables.


METHODS
This single-center study examined short-term and long-term outcomes for colorectal cancer in 258 patients who underwent laparoscopic resection (LC) and 258 matched open resection (OC) cases. The health-related qualities of life (HRQOL) at 1-2 years after the operations in 62 patients (35 LC and 27 OC) were compared by SF-36.


RESULTS
The conversion rate was 5.0%. Mean follow-up periods in LC and OC were 62.3 and 62.1 months, respectively. Operation time was longer in LC than in OC, although the difference was not significant in the later period. Bleeding and postoperative stay were reduced in LC. The morbidity rate was 18.6% in LC and 26.4% in OC. The 5-year overall survival in LC and OC were 94.6% vs. 92.0% for stage I, 95.2% vs. 91.8% for stage II, and 80.9% vs. 79.1% for stage III, respectively. The corresponding 5-year disease-free survival were 94.0% vs. 88.4%, 92.1% vs. 84.0%, and 64.3% vs. 65.4%, respectively. Recurrence rates did not differ between groups. In the analysis of HRQOL scores, role physical, bodily pain, social functioning, role emotional, and physical component summary scores in LC were better than in OC.


CONCLUSIONS
In LC for colorectal cancer, short-term outcomes except operation time and mid-term HRQOL were better than in OC, and there were no adverse effects relating to long-term outcomes.
Fujii
Shoichi
S
Department of Surgery, Gastroenterological Center, Yokohama City University, 4-57 Urafunecho, Minami-ku, Yokohama, Japan. u0970047@urahp.yokohama-cu.ac.jp
Ota
Mitsuyoshi
M
Ichikawa
Yasushi
Y
Yamagishi
Shigeru
S
Watanabe
Kazuteru
K
Tatsumi
Kenji
K
Watanabe
Jun
J
Suwa
Hirokazu
H
Oshima
Takashi
T
Kunisaki
Chikara
C
Ohki
Shigeo
S
Endo
Itaru
I
Shimada
Hiroshi
H
D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D003710:Demography; D018572:Disease-Free Survival; D005260:Female; D006262:Health; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011788:Quality of Life; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome