Outcomes of laparoscopic colon cancer surgery in a population-based cohort in British Columbia: are they as good as the clinical trials?

This study published in the American Journal of Surgery evaluated the outcomes of lap-assisted colectomy (LAC) vs open colectomy (OC) at a population level. They used prospectively collected data from the Gastrointestinal Cancer Outcomes Unit database from the British Columbia Cancer Agency from 2003 to 2008 inclusive. They found a statistically significant increase in the proportion of LAC from 2003 to 2008 (P < .001). LAC was more likely to be performed in the elective setting (P < .001) and for smaller tumors (P < .001). A similar proportion of patients had a minimum of 12 lymph nodes identified by pathology (58% vs 60%, P = not significant). Disease-free survival was similar for the 2 groups after adjusting for stage, emergency presentation, and adjuvant chemotherapy. There was no difference in overall survival. This study suggests that introduction of LAC for colon cancer outside of optimized clinical trial conditions appears to give similar results to OC.

Am J Surg 2012;doi:10.1016/j.amjsurg.2011.11.015

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Synopsis provided by the schoolofsurgery.org

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