Laparoscopic Colectomy: A Risk Factor for Postoperative Peritoneal Metastasis.
Colon cancer
Laparoscopic surgery
Peritoneal metastasis
Journal
Clinical colorectal cancer
ISSN: 1938-0674
Titre abrégé: Clin Colorectal Cancer
Pays: United States
ID NLM: 101120693
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
received:
02
04
2022
revised:
12
05
2022
accepted:
15
05
2022
pubmed:
13
6
2022
medline:
9
9
2022
entrez:
12
6
2022
Statut:
ppublish
Résumé
The oncologic outcomes are generally considered equivalent for both laparoscopic and open surgery. However, our previous single-center study found a greater risk of postoperative peritoneal metastasis (PM) after laparoscopic colectomy (LC) than after open colectomy (OC) in patients with pathological T4a (pT4a) colon cancer. This multicenter study aimed to clarify if the risk of PM was increased after LC. This study used the multicenter database of the Japanese Study Group for Postoperative Follow-up of Colorectal Cancer, which included patients with colorectal cancer treated between 1997 and 2012 in 24 referral hospitals across Japan. The analysis included 17,323 patients with pathological stage I-III colon cancer, including 2380 patients with pT4a disease. The risk of PM was compared between the LC and OC groups. The cumulative incidence of PM was significantly higher after LC in patients with pT4a colon cancer (13.0% vs. 7.7%; P = .001). Multivariable analyses showed LC was a significant risk factor for PM (hazard ratio [HR]: 1.36, 95% confidence interval [CI]: 1.04-1.78, P = .023), which was confirmed by propensity score analyses (HR: 1.36, 95% CI: 1.04-1.78, P = .024). This study demonstrated a significant increase in the risk of PM after LC than after OC.
Sections du résumé
BACKGROUND
The oncologic outcomes are generally considered equivalent for both laparoscopic and open surgery. However, our previous single-center study found a greater risk of postoperative peritoneal metastasis (PM) after laparoscopic colectomy (LC) than after open colectomy (OC) in patients with pathological T4a (pT4a) colon cancer. This multicenter study aimed to clarify if the risk of PM was increased after LC.
METHODS
This study used the multicenter database of the Japanese Study Group for Postoperative Follow-up of Colorectal Cancer, which included patients with colorectal cancer treated between 1997 and 2012 in 24 referral hospitals across Japan. The analysis included 17,323 patients with pathological stage I-III colon cancer, including 2380 patients with pT4a disease. The risk of PM was compared between the LC and OC groups.
RESULTS
The cumulative incidence of PM was significantly higher after LC in patients with pT4a colon cancer (13.0% vs. 7.7%; P = .001). Multivariable analyses showed LC was a significant risk factor for PM (hazard ratio [HR]: 1.36, 95% confidence interval [CI]: 1.04-1.78, P = .023), which was confirmed by propensity score analyses (HR: 1.36, 95% CI: 1.04-1.78, P = .024).
CONCLUSION
This study demonstrated a significant increase in the risk of PM after LC than after OC.
Identifiants
pubmed: 35691832
pii: S1533-0028(22)00057-3
doi: 10.1016/j.clcc.2022.05.003
pii:
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e205-e212Informations de copyright
Copyright © 2022. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Conflict of Interest None