title: Laparoscopic vs. open surgery for T4 colon cancer: A propensity score analysis.
abstract: OBJECTIVE
  The study aimed to compare, using propensity score matching (PSM) analyses, the short- and long-term results of laparoscopic colectomy (LC) versus open colectomy (OC) in a bicentric cohort of patients with T4 colon cancer.
  
  
  METHODS
  This is a retrospective PSM analysis of consecutive patients undergoing elective LC or OC for pT4 colon cancer (TNM stage II/III) between 2005 and 2014.
  
  
  RESULTS
  Overall, 237 patients were selected. After PSM, 106 LC-and 106 OC-matched patients were compared. LC was associated with longer operative time and lower blood loss than OC (220 vs. 190 min, p < 0.0001; 116 vs. 150 mL, p = 0.002, respectively). LC patients showed a faster recovery, which translated into a shorter hospital stay compared to OC (10.5 vs. 15.3 days, p < 0.0001). Conversion was required in 13 (12.2 %) LC patients. No group difference was observed for 30- and 90-day mortality. R0 resection was achieved in the majority of LC and OC patients (93.9 %). The 1-, 3-, and 5-year overall survival was 99, 76.8, and 58.6 %, respectively, for the LC group and 98, 70.1, and 59.9 %, respectively, for the OC group (p = 0.864). The 1-, 3-, and 5-year disease-free survival was 86.3, 66, 57.6 %, respectively, for the LC group and 79.1, 55.1, and 50.2 % for the OC group (p = 0.261).
  
  
  CONCLUSIONS
  With an acceptable conversion rate, laparoscopy can achieve complete oncologic resections of T4 colon cancer similar to open surgery and can be considered a safe and feasible alternative approach that confers the advantage of a faster recovery.
authors.affiliation: Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Créteil, France. nic.deangelis@yahoo.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: de'Angelis
authors.affiliation: Divisions of Transplant and Abdominal Surgery, Department of Surgery, University of Geneva Hospitals, Geneva, Switzerland.
authors.forename: Giulio Cesare
authors.initials: GC
authors.lastname: Vitali
authors.affiliation: Unit of Digestive, Hepato-Pancreato-Biliary Surgery, and Liver Transplantation, Henri Mondor Hospital, AP-HP, Créteil, France.
authors.forename: Francesco
authors.initials: F
authors.lastname: Brunetti
authors.affiliation: Divisions of Transplant and Abdominal Surgery, Department of Surgery, University of Geneva Hospitals, Geneva, Switzerland.
authors.forename: Charles-Henri
authors.initials: CH
authors.lastname: Wassmer
authors.affiliation: Department of Gastroenterology and Digestive Endoscopy, Henri Mondor Hospital, AP-HP, Creteil, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gagniere
authors.affiliation: Division of Clinical Pathology, University of Geneva Hospitals, Geneva, Switzerland.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Puppa
authors.affiliation: Medical Oncology Department, Henri Mondor Hospital, AP-HP, Créteil, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tournigand
authors.affiliation: Divisions of Transplant and Abdominal Surgery, Department of Surgery, University of Geneva Hospitals, Geneva, Switzerland.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Ris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D003710:Demography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011182:Postoperative Care; D057216:Propensity Score; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D055815:Young Adult
keywords: Colon cancer; Laparoscopic colectomy; Locally advanced colon cancer; Open colectomy; Propensity score matching