title: 10-Year Oncologic Outcomes After Laparoscopic or Open Total Mesorectal Excision for Rectal Cancer.
abstract: Only few studies have compared laparoscopic total mesorectal excision (LTME) and open total mesorectal excision (OTME) for rectal cancer with follow-up longer than 5 years. The aim of this study was to compare 10-year oncologic outcomes after LTME and OTME for nonmetastatic rectal cancer.
  
  
  
  We conducted a retrospective analysis of a prospective database of rectal cancer patients undergoing LTME or OTME. Statistical analyses were performed on an ''intention-to-treat'' basis and by actual treatment. Overall survival (OS) and disease-free survival (DFS) were compared by using the Kaplan-Meier method. A multivariable analysis was performed to identify predictors of poor survival.
  
  
  
  Between April 1994 and August 2005, a total of 153 LTME patients and 154 OTME patients were included. Similarly, 10-year OS and DFS after LTME and OTME were observed: 76.8 versus 70.6 % (P = 0.138) and 69.1 versus 67.6 % (P = 0.508), respectively. Conversion to OTME did not adversely affect OS and DFS. Stage-by-stage comparison showed no significant differences between LTME and OTME. No significant differences were observed in local recurrence rates after LTME and OTME (6.5 vs. 7.8 %, P = 0.837). Median time until local recurrence was 24.5 (range, 12-56) months after LTME and 22 (6-64) months after OTME (P = 0.777). Poor tumor differentiation, lymphovascular invasion, and a lymph node ratio of 0.25 or more were the independent predictors of poorer OS and DFS.
  
  
  
  This retrospective study with long follow-up did not show significant differences between the two groups in OS and DFS.
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy. meallaix@gmail.com.
authors.forename: Marco E
authors.initials: ME
authors.lastname: Allaix
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Giraudo
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Ferrarese
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Arezzo
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Rebecchi
authors.affiliation: Department of Surgical Sciences, University of Torino, Corso Dogliotti 14, 10126, Torino, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Morino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology; D013505:Digestive System Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008198:Lymph Nodes / Q000473:pathology; D042601:Lymphatic Vessels / Q000473:pathology; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000209:etiology; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome