title: Short- and Long-Term Outcomes of Laparoscopic Multivisceral Resection for Clinically Suspected T4 Colon Cancer.
abstract: The use of laparoscopic surgery for colorectal cancer has become widespread recently. However, the safety and oncological outcomes of laparoscopic surgery for primary advanced colorectal cancer need extensive investigation. We analyzed the short- and long-term outcomes after laparoscopic multivisceral resection for primary colon cancer with suspected invasion of other organs at a single institution.
  
  
  
  Between January 2000 and December 2014, 118 patients underwent laparoscopic multivisceral resection for primary colon cancer invading or adhering to adjacent organs or structures; their short- and long-term outcomes were retrospectively evaluated.
  
  
  
  The median operating time was 254 min (range 130-1051 min), and median blood loss was 48 ml (range 0-2777 ml). The overall conversion rate was 6.8%. The postoperative complication rate was 17.8%. The number of patients with R0 and R1 resection was 112 (94.9%) and 6 (5.1%), respectively. At a median follow-up period of 32 months (range 0-157 months), the local recurrence rate in patients who underwent R0 resection was 1.8%, while for R1 resection it was 66.7%. In multivariate analysis, R1 resection and LN metastases were found to be predictors of poor prognosis. The cancer-specific 5-year survival was 87% when R0 resection was achieved; within these, the 5-year survival rates for patients with stages II, III, and IV disease were 94, 81, and 40%, respectively.
  
  
  
  Laparoscopic en bloc multivisceral resection for clinically suspected T4 colon cancer is a safe and feasible procedure for precisely selected patients, attaining satisfactory oncological outcomes when R0 resection is achieved.
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan. k-s-tomu@amber.plala.or.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kumamoto
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Toda
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Matoba
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors.forename: Jin
authors.initials: J
authors.lastname: Moriyama
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Hanaoka
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tomizawa
authors.affiliation: Department of Colorectal Surgery, Yokoyama Hospital, Miyazaki, Japan.
authors.forename: Toshihito
authors.initials: T
authors.lastname: Sawada
authors.affiliation: Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kuroyanagi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D061646:Operative Time; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome