title: Comparing oncological outcomes of laparoscopic versus open surgery for colon cancer: Analysis of a large prospective clinical database.
abstract: BACKGROUND
  Oncological outcomes of laparoscopic colon cancer surgery have been shown to be equivalent to those of open surgery, but only in the setting of randomized controlled trials on highly selected patients. The aim of this study is to investigate whether this finding is generalizable to real world practice.
  
  
  METHODS
  Analysis of prospectively collected data from the BioGrid Australia database was undertaken. Overall and cancer specific survival rates were compared with cox regression analysis controlling for the confounders of age, sex, BMI, ASA score, hospital site, year surgery performed, procedure, tumor stage, and adjuvant chemotherapy.
  
  
  RESULTS
  Between 2003 and 2009, 1,106 patients underwent elective colon cancer resection. There were differences between the laparoscopic and open cohorts in BMI, procedure, post-operative complication rate, and tumor stage. When baseline confounders were accounted for using cox regression analysis, there was no difference in 5 year overall survival (χ(2) test 1.302, P = 0.254), or cancer specific survival (χ(2) test 0.028, P = 0.866).
  
  
  CONCLUSIONS
  This large prospective clinical study validates previous trial results, and confirms that there is no difference in oncological outcome between laparoscopic and open surgery for colon cancer.
authors.affiliation: Department of Surgery, The Royal Melbourne Hospital, VIC, Australia.
authors.forename: T
authors.initials: T
authors.lastname: Sammour
authors.forename: Ian T
authors.initials: IT
authors.lastname: Jones
authors.forename: P
authors.initials: P
authors.lastname: Gibbs
authors.forename: R
authors.initials: R
authors.lastname: Chandra
authors.forename: Malcolm C
authors.initials: MC
authors.lastname: Steel
authors.forename: Susan M
authors.initials: SM
authors.lastname: Shedda
authors.forename: M
authors.initials: M
authors.lastname: Croxford
authors.forename: I
authors.initials: I
authors.lastname: Faragher
authors.forename: Ian P
authors.initials: IP
authors.lastname: Hayes
authors.forename: Ian A
authors.initials: IA
authors.lastname: Hastie
mesh_terms: D000368:Aged; D001315:Australia; D003082:Colectomy / Q000401:mortality*; D003110:Colonic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate
keywords: colon cancer; laparoscopy; oncology; rectal cancer; survival