Five-year long-term outcomes of laparoscopic surgery for colon cancer.
OBJECTIVE
To perform a meta-analysis to answer whether long-term recurrence rates after laparoscopic-assisted surgery are comparable to those reported after open surgery.


METHODS
A comprehensive literature search of the MEDLINE database, EMBASE database, and the Cochrane Central Register of Controlled Trials for the years 1991-2010 was performed. Prospective randomized clinical trials (RCTs) were eligible if they included patients with colon cancer treated by laparoscopic surgery vs open surgery and followed for more than five years.


RESULTS
Three studies involving 2147 patients reported long-term outcomes based on five-year data and were included in the analysis. The overall mortality was similar in the two groups (24.9%, 268/1075 in the laparoscopic group and 26.4%, 283/1072 in open group). No significant differences between laparoscopic and open surgery were found in overall mortality during the follow-up period of these studies [OR (fixed) 0.92, 95% confidence intervals (95% CI): 0.76-1.12, P = 0.41]. No signiﬁcant difference in the development of overall recurrence was found in colon cancer patients, when comparing laparoscopic and open surgery [2147 pts, 19.3% vs 20.0%; OR (ﬁxed) 0.96, 95% CI: 0.78-1.19, P = 0.71].


CONCLUSIONS
This meta-analysis suggests that laparoscopic surgery was as efficacious and safe as open surgery for colon cancer, based on the five-year data of these included RCTs.
Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guo Xue Rd, Chengdu 610041, Sichuan Province, China.
Hai-Long
HL
Bai
Bin
B
Chen
Yong
Y
Zhou
Xiao-Ting
XT
Wu
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D016009:Chi-Square Distribution; D002681:China; D003082:Colectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D019317:Evidence-Based Medicine; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000401:mortality; D016017:Odds Ratio; D018579:Patient Selection; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome