title: Laparoscopic versus open resection for colon cancer: 10-year outcomes of a prospective clinical trial.
abstract: BACKGROUND
  Laparoscopic resection (LR) and open resection (OR) for colon cancer have similar oncologic outcomes at 5-year follow-up. However, results from studies with longer follow-up are limited. This study aimed to compare 10-year oncologic outcomes of LR and OR for non-metastatic colon cancer.
  
  
  METHODS
  A prospective non-randomized trial comparing patients undergoing LR or OR for non-metastatic colon cancer at a single institution was conducted. Statistical analyses were performed on an ''intention-to-treat'' basis and by actual treatment. Kaplan-Meier curves were compared to analyze overall survival (OS) and disease-free survival (DFS). A multivariate analysis was performed to identify predictors of poor survival.
  
  
  RESULTS
  The study included 304 colon cancer patients: 154 patients underwent LR and 150 underwent OR. Fifteen (9.7 %) had LR converted to OR. During a median follow-up period of 138 (range, 120-220) months, no significant differences were observed between LR and OR patients in 10-year OS and DFS rates: 87.2 % versus 78.7 % (P = 0.182) and 80.9 % versus 76.8 % (P = 0.444), respectively. Conversion to open surgery was associated with a non-significant reduction in OS and DFS. Stage-by-stage comparison showed no significant differences between the two groups. Both OS and DFS were similar between right colon and left-sided colon cancer patients. On multivariate analysis, pT4 cancer and a lymph node ratio of 0.20 or more were the only independent predictors of both OS and DFS.
  
  
  CONCLUSIONS
  The 10-year follow-up results confirm the oncological effectiveness of the laparoscopic approach to non-metastatic colon cancer.
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Turin, Italy, meallaix@gmail.com.
authors.forename: Marco E
authors.initials: ME
authors.lastname: Allaix
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giraudo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Mistrangelo
authors.forename: Alberto
authors.initials: A
authors.lastname: Arezzo
authors.forename: Mario
authors.initials: M
authors.lastname: Morino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D061887:Conversion to Open Surgery; D018572:Disease-Free Survival; D005260:Female; D005544:Forecasting; D006801:Humans; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome; D055815:Young Adult
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