Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience
<i>Background and objectives:</i> When resecting colon adenocarcinoma, surgeons decide between the use of laparoscopically assisted and open surgery. Laparoscopic resection is known to have short-term benefits over an open operation. However, researchers are not as unified about the long...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-02-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/2/93 |
| _version_ | 1797722946084536320 |
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| author | Jurij Janež Armand D Škapin |
| author_facet | Jurij Janež Armand D Škapin |
| author_sort | Jurij Janež |
| collection | DOAJ |
| description | <i>Background and objectives:</i> When resecting colon adenocarcinoma, surgeons decide between the use of laparoscopically assisted and open surgery. Laparoscopic resection is known to have short-term benefits over an open operation. However, researchers are not as unified about the long-term findings. The aim of this research is to elaborate on five-year post-operative differences in survival and cancer recurrence between these two different approaches. <i>Materials and methods:</i> 74 enrolled patients were evaluated five years after a primary operation. We collected dates of deaths of deceased patients and time after operation of possible recurrences. Carcinoma staging was done by a pathologist after operation. Blood samples were taken before surgery in order to measure tumor markers (CA19-9 and CEA). <i>Results:</i> Survival after colonic adenocarcinoma surgery did not differ between the two different surgical approaches (<i>p</i> = 0.151). Recurrence of cancer was not associated with the type of operation (<i>p</i> = 0.532). Patients with recurrence had a 37.6 times greater hazard ratio of dying (95% CI: [12.0, 118]; <i>p</i> < 0.001). Advanced age adversely affected survival: patients aged <65 and ≥65 years had a 97%, and 57% survival rate, respectively. Patients with elevated tumor markers at operation had a 19.1 greater hazard ratio of dying (95% CI: [5.16, 70.4]; <i>p</i> < 0.001). Patients with different TNM stages did not have any statistically significant differences in survival (HR<sub>II</sub> = 2.49; 95% CI: [0.67, 9.30]; p<sub>II</sub> = 0.173) (HR<sub>III</sub> = 2.18; 95% CI: [0.58, 8.12]; p<sub>III</sub> = 0.246) or recurrence (<i>p</i> = 0.097). <i>Conclusion:</i> The obtained results suggest that laparoscopic resection of colon cancer is not inferior from an oncologic point of view and results in a similar long-term survival and disease-free interval. Recurrence of carcinoma, older age at initial operation and elevated tumor markers, above a pre-set threshold at operation, were found to be independent factors of lower survival. We believe that the obtained results will be of benefit when choosing treatment for colon adenocarcinoma. |
| first_indexed | 2024-03-12T09:56:04Z |
| format | Article |
| id | doaj.art-0baeeac9e0b94c62bd18740fc14ccdac |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T09:56:04Z |
| publishDate | 2020-02-01 |
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| series | Medicina |
| spelling | doaj.art-0baeeac9e0b94c62bd18740fc14ccdac2023-09-02T12:11:10ZengMDPI AGMedicina1010-660X2020-02-015629310.3390/medicina56020093medicina56020093Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre ExperienceJurij Janež0Armand D Škapin1Department of Abdominal Surgery, University Medical Centre Ljubljana, 1000 Ljubljana, SloveniaFaculty of Medicine, University of Ljubljana, 1104 Ljubljana, Slovenia<i>Background and objectives:</i> When resecting colon adenocarcinoma, surgeons decide between the use of laparoscopically assisted and open surgery. Laparoscopic resection is known to have short-term benefits over an open operation. However, researchers are not as unified about the long-term findings. The aim of this research is to elaborate on five-year post-operative differences in survival and cancer recurrence between these two different approaches. <i>Materials and methods:</i> 74 enrolled patients were evaluated five years after a primary operation. We collected dates of deaths of deceased patients and time after operation of possible recurrences. Carcinoma staging was done by a pathologist after operation. Blood samples were taken before surgery in order to measure tumor markers (CA19-9 and CEA). <i>Results:</i> Survival after colonic adenocarcinoma surgery did not differ between the two different surgical approaches (<i>p</i> = 0.151). Recurrence of cancer was not associated with the type of operation (<i>p</i> = 0.532). Patients with recurrence had a 37.6 times greater hazard ratio of dying (95% CI: [12.0, 118]; <i>p</i> < 0.001). Advanced age adversely affected survival: patients aged <65 and ≥65 years had a 97%, and 57% survival rate, respectively. Patients with elevated tumor markers at operation had a 19.1 greater hazard ratio of dying (95% CI: [5.16, 70.4]; <i>p</i> < 0.001). Patients with different TNM stages did not have any statistically significant differences in survival (HR<sub>II</sub> = 2.49; 95% CI: [0.67, 9.30]; p<sub>II</sub> = 0.173) (HR<sub>III</sub> = 2.18; 95% CI: [0.58, 8.12]; p<sub>III</sub> = 0.246) or recurrence (<i>p</i> = 0.097). <i>Conclusion:</i> The obtained results suggest that laparoscopic resection of colon cancer is not inferior from an oncologic point of view and results in a similar long-term survival and disease-free interval. Recurrence of carcinoma, older age at initial operation and elevated tumor markers, above a pre-set threshold at operation, were found to be independent factors of lower survival. We believe that the obtained results will be of benefit when choosing treatment for colon adenocarcinoma.https://www.mdpi.com/1010-660X/56/2/93colon cancersurvivalrecurrencesurgerylaparoscopy |
| spellingShingle | Jurij Janež Armand D Škapin Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience Medicina colon cancer survival recurrence surgery laparoscopy |
| title | Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience |
| title_full | Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience |
| title_fullStr | Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience |
| title_full_unstemmed | Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience |
| title_short | Comparison of a Five-Year Survival and Cancer Recurrence between Laparoscopically Assisted and Open Colonic Resections due to Adenocarcinoma—A Single Centre Experience |
| title_sort | comparison of a five year survival and cancer recurrence between laparoscopically assisted and open colonic resections due to adenocarcinoma a single centre experience |
| topic | colon cancer survival recurrence surgery laparoscopy |
| url | https://www.mdpi.com/1010-660X/56/2/93 |
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