title: Outcome after introduction of complete mesocolic excision for colon cancer is similar for open and laparoscopic surgical treatments.
abstract: BACKGROUND
  Complete mesocolic excision (CME) and a high (apical) vascular tie may improve oncologic outcome after surgery for colon cancer. Our primary aim was to emulate a previous national result of 73.8% overall survival (OS) with both the open and laparoscopic techniques.
  
  
  METHODS
  A prospective study of radical colon cancer was initiated in a Norwegian community teaching hospital in 2007 and comprised a consecutive group of 251 patients with TNM stages I-III that had surgery according to the CME principle. Oncological outcome was assessed as OS, disease-free survival (DFS) and cancer-specific survival (CSS), as well as time to recurrence (TTR), using Cox regression analysis.
  
  
  RESULTS
  In-hospital mortality was 3.6%, 2.3% for laparoscopic surgery and 4.9% for open management. Significantly more patients in the open CME group developed complications in the short term (p < 0.001). Twelve or more lymph nodes were retrieved from 82.9% (208/251) of the specimens. Overall 3-year OS was 84.5%, DFS 77.4%, CSS 91.5% and TTR 86.8%. The surgical approach was not a significant predictor for any of the survival parameters.
  
  
  CONCLUSIONS
  There was no survival difference between open and laparoscopic CME colonic resections, and the present OS improved from a previous OS from 2000.
authors.affiliation: Department of Surgery, Haraldsplass Deaconess Hospital, University of Bergen, Bergen, Norway.
authors.forename: Kristian E
authors.initials: KE
authors.lastname: Storli
authors.forename: Karl
authors.initials: K
authors.lastname: Søndenaa
authors.forename: Bjørg
authors.initials: B
authors.lastname: Furnes
authors.forename: Geir Egil
authors.initials: GE
authors.lastname: Eide
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods* / Q000401:mortality*; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D011446:Prospective Studies; D016896:Treatment Outcome