Survival outcomes following laparoscopic vs open surgery for non-metastatic rectal cancer: a two-center cohort study with propensity score matching. (19th August 2020)

• Record Type: Journal Article
• Authors: Tan, Kang-Lian; Deng, Hai-Jun; Chen, Zhi-Qiang; Mou, Ting-Yu; Liu, Hao; Xie, Run-Sheng; Liang, Xue-Min; Fan, Xiao-Hua; Li, Guo-Xin
• Is Part Of: Gastroenterology report. Volume 8:Number 4(2020)
• Page Start: 319
• Page End: 325
• Publication Date: 2020-08-19
• Subjects: laparoscopic surgery -- open surgery -- propensity score matching -- rectal cancer; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1093/gastro/goaa046
• Languages: English
• ISSNs: 2052-0034

Abstract

Abstract: Background:?>: Laparoscopic surgery for rectal cancer is commonly performed in China. However, compared with open surgery, the effectiveness of laparoscopic surgery, especially the long-term survival, has not been sufficiently proved. Methods:?>: Data of eligible patients with non-metastatic rectal cancer at Nanfang Hospital of Southern Medical University and Guangdong Provincial Hospital of Chinese Medicine between 2012 and 2014 were retrospectively reviewed. Long-term survival outcomes and short-term surgical safety were analysed with propensity score matching between groups. Results: Of 430 cases collated from two institutes, 103 matched pairs were analysed after propensity score matching. The estimated blood loss during laparoscopic surgery was significantly less than that during open surgery ( P = 0.019) and the operative time and hospital stay were shorter in the laparoscopic group (both P < 0.001). The post-operative complications rate was 9.7% in the laparoscopic group and 10.7% in the open group ( P = 0.818). No significant difference was observed between the laparoscopic group and the open group in the 5-year overall survival rate (75.7% vs 80.6%, P = 0.346), 5-year relapse-free survival rate (74.8% vs 76.7%, P = 0.527), or 5-year cancer-specific survival rate (79.6% vs 87.4%, P = 0.219). An elevated carcinoembryonic antigen, <12 harvested lymph nodes, and perineural invasion were independent prognostic factors affecting overall survival and relapse-free survival. Conclusions:?>: Our findings suggest that open surgery should still be the priority recommendation, but laparoscopic surgery is also an acceptable treatment for non-metastatic rectal cancer.