title: Survival after laparoscopic and open surgery for colon cancer: a comparative, single-institution study.
abstract: BACKGROUND
  Some recent studies have suggested that laparoscopic surgery for colorectal cancer may provide a potential survival advantage when compared with open surgery. This study aimed to compare cancer-related survivals of patients who underwent laparoscopic or open resection of colon cancer in the same, high volume tertiary center.
  
  
  METHODS
  Patients who had undergone elective open or laparoscopic surgery for colon cancer between January 2002 and December 2010 were analyzed. A clinical database was prospectively compiled. Survival analysis was calculated by using the Kaplan-Meier method.
  
  
  RESULTS
  A total of 460 resections were performed. There were no significant differences between the laparoscopic (n = 227) and the open group (n = 233) apart from tumor stage: stage I tumors were more frequent in the laparoscopic group whereas stage II tumors were more frequent in the open group. The mean number of harvested lymph nodes was significantly higher in the laparoscopic than in the open group (20.0 ± 0.7 vs 14.2 ± 0.5, P < 0.01). The 5-year cancer-related survival for patients undergoing laparoscopic resection was significantly higher than that following open resections (83.1% vs 68.5%, P = 0.01). By performing a stage-to-stage comparison, we found that the improvement in survival in the laparoscopic group occurred mainly in patients with stage II tumors.
  
  
  CONCLUSIONS
  Our study shows a survival advantage for patients who had undergone laparoscopic surgery for stage II colon cancer. This may be correlated with a higher number of harvested lymph nodes and thus a better stage stratification of these patients.
authors.affiliation: Center of Oncological Minimally Invasive Surgery (COMIS), Department of Surgery and Translational Medicine, University of Florence, Italy Largo Brambilla 3, 50134, Florence, Italy. fabio.cianchi@unifi.it.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cianchi
authors.affiliation: Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Trallori
authors.affiliation: ISPO, Florence, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Mallardi
authors.affiliation: Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Macrì
authors.affiliation: Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Biagini
authors.affiliation: Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Lami
authors.affiliation: IFCA, Florence, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Indennitate
authors.affiliation: Unit of Gastroenterology, AOU Careggi, Florence, Italy.
authors.forename: Siro
authors.initials: S
authors.lastname: Bagnoli
authors.affiliation: Unit of Gastroenterology, AOU Careggi, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bonanomi
authors.affiliation: Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Messerini
authors.affiliation: Center of Oncological Minimally Invasive Surgery (COMIS), Department of Surgery and Translational Medicine, University of Florence, Italy Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Badii
authors.affiliation: Center of Oncological Minimally Invasive Surgery (COMIS), Department of Surgery and Translational Medicine, University of Florence, Italy Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Staderini
authors.affiliation: Center of Oncological Minimally Invasive Surgery (COMIS), Department of Surgery and Translational Medicine, University of Florence, Italy Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Ileana
authors.initials: I
authors.lastname: Skalamera
authors.affiliation: Center of Oncological Minimally Invasive Surgery (COMIS), Department of Surgery and Translational Medicine, University of Florence, Italy Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Fiorenza
authors.affiliation: Center of Oncological Minimally Invasive Surgery (COMIS), Department of Surgery and Translational Medicine, University of Florence, Italy Largo Brambilla 3, 50134, Florence, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Perigli
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome