title: Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer.
abstract: Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up.
  
  
  
  Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842).
  
  
  
  In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) -10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI -10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI -11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n = 3 vs. open n = 4).
  
  
  
  Laparoscopic surgery for non-metastatic colon cancer is associated with similar rates of disease-free survival, overall survival and recurrences as open surgery at 10-year follow-up.
authors.affiliation: Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Charlotte L
authors.initials: CL
authors.lastname: Deijen
authors.affiliation: Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Jeanine E
authors.initials: JE
authors.lastname: Vasmel
authors.affiliation: Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Elly S M
authors.initials: ESM
authors.lastname: de Lange-de Klerk
authors.affiliation: Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Cuesta
authors.affiliation: Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
authors.forename: Peter-Paul L O
authors.initials: PLO
authors.lastname: Coene
authors.affiliation: Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Johan F
authors.initials: JF
authors.lastname: Lange
authors.affiliation: Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: W J H Jeroen
authors.initials: WJHJ
authors.lastname: Meijerink
authors.affiliation: Department of Design Engineering, Delft University of Technology, Delft, The Netherlands.
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Jakimowicz
authors.affiliation: Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Jeekel
authors.affiliation: Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
authors.forename: Geert
authors.initials: G
authors.lastname: Kazemier
authors.affiliation: Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
authors.forename: Ignace M C
authors.initials: IMC
authors.lastname: Janssen
authors.affiliation: Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Påhlman
authors.affiliation: Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Haglind
authors.affiliation: Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. j.bonjer@vumc.nl.
authors.forename: H Jaap
authors.initials: HJ
authors.lastname: Bonjer
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005006:Ethnicity; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000601:surgery*; D009426:Netherlands; D015996:Survival Rate
keywords: Colon cancer; Laparoscopic; Randomised clinical trial; Surgery; Treatment