title: Long-term oncologic outcome after laparoscopic surgery for rectal cancer.
abstract: BACKGROUND
  Recent studies demonstrated favorable short- and mid-term results after laparoscopic surgery for rectal cancer. However, long-term results from large series are lacking. The present study analyses long-term results of laparoscopic rectal cancer surgery from a large-volume center.
  
  
  METHODS
  From January 1998 until March 2005, 225 patients underwent laparoscopic rectal resection due to carcinoma at the Medical Centre of the University of Regensburg. From 224 patients, a follow-up over 10 years was performed using the data of the Tumour Centre of the University of Regensburg. The data were analysed using oncological data (tumour recurrence) as well as overall survival. In addition, the effect of conversion to open resection on overall survival was analysed.
  
  
  RESULTS
  With a median of 10 years at follow-up, the overall and disease-free survival was 50.5 and 50.1 %, respectively. Local recurrence of all patients was 5.8 % and none of the converted patients was within this group. The median time interval for the development of local recurrence was 30 months. Six of the 13 patients with local recurrence (46.1 %) had received neoadjuvant radiochemotherapy before surgery. Patients with a conversion to open surgery had primarily a significantly worse outcome than patients resected completely laparoscopically (p = 0.003). However, this difference was no longer apparent using a multivariant analysis (hazard ratio 1.221; p = 0.478).
  
  
  CONCLUSIONS
  Overall survival and local recurrence rate of patients undergoing laparoscopic resection of rectal cancer are comparable to open surgery. However, in our analysis, patients undergoing laparoscopic anterior resection had a higher survival rate compared with patients with abdominoperineal resection.
authors.affiliation: Department of Surgery, University Medical Centre Regensburg, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany.
authors.forename: Ayman
authors.initials: A
authors.lastname: Agha
authors.forename: Volker
authors.initials: V
authors.lastname: Benseler
authors.forename: Matthias
authors.initials: M
authors.lastname: Hornung
authors.forename: Michael
authors.initials: M
authors.lastname: Gerken
authors.forename: Igors
authors.initials: I
authors.lastname: Iesalnieks
authors.forename: Alois
authors.initials: A
authors.lastname: Fürst
authors.forename: Matthias
authors.initials: M
authors.lastname: Anthuber
authors.forename: Karl-Walter
authors.initials: KW
authors.lastname: Jauch
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Schlitt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D061887:Conversion to Open Surgery; D018572:Disease-Free Survival; D005260:Female; D005544:Forecasting; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends