title: Long-term outcomes of the australasian randomized clinical trial comparing laparoscopic and conventional open surgical treatments for colon cancer: the Australasian Laparoscopic Colon Cancer Study trial.
abstract: OBJECTIVE
  : We report a multicentered randomized controlled trial across Australia and New Zealand comparing laparoscopic-assisted colon resection (LCR) with open colon resection (OCR) for colon cancer.
  
  
  BACKGROUND
  : Colon cancer is a significant worldwide health issue. This trial investigated whether the short-term benefits associated with LCR for colon cancer could be achieved safely, without survival disadvantages, in our region.
  
  
  METHODS
  : A total of 601 patients with potentially curable colon cancer were randomized to receive LCR or OCR. Primary endpoints were 5-year overall survival, recurrence-free survival, and freedom from recurrence rates, compared using an intention-to-treat analysis.
  
  
  RESULTS
  : On April 5, 2010, 587 eligible patients were followed for a median of 5.2 years (range, 1 week-11.4 years) with 5-year confirmed follow-up data for survival and recurrence on 567 (96.6%). Significant differences between the 2 trial groups were as follows: LCR patients were older at randomization, and their pathology specimens showed smaller distal resection margins; OCR patients had some worse pathology parameters, but there were no differences in disease stages. There were no significant differences between the LCR and OCR groups in 5-year follow-up of overall survival (77.7% vs 76.0%, P = 0.64), recurrence-free survival (72.7% vs 71.2%, P = 0.70), or freedom from recurrence (86.2% vs 85.6%, P = 0.85).
  
  
  CONCLUSIONS
  : In spite of some differences in short-term surrogate oncological markers, LCR was not inferior to OCR in direct measures of survival and disease recurrence. These findings emphasize the importance of long-term data in formulating evidence-based practice guidelines.
authors.affiliation: Department of Surgery, University of Otago, Christchurch, New Zealand. bagshaw@clear.net.nz
authors.forename: Philip F
authors.initials: PF
authors.lastname: Bagshaw
authors.forename: Randall A
authors.initials: RA
authors.lastname: Allardyce
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Frampton
authors.forename: Francis A
authors.initials: FA
authors.lastname: Frizelle
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hewett
authors.forename: Paul J
authors.initials: PJ
authors.lastname: McMurrick
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Rieger
authors.forename: J Shona
authors.initials: JS
authors.lastname: Smith
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Solomon
authors.forename: Andrew R L
authors.initials: AR
authors.lastname: Stevenson
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery*; D000368:Aged; D001315:Australia; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009520:New Zealand; D016896:Treatment Outcome