Affiliation:
1. Department of Surgical Oncology Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan
2. Department of Surgery National Hospital Organization Ureshino Medical Center Ureshino Japan
3. Department of Surgery National Hospital Organization Nagasaki Medical Center Ohmura Japan
4. Department of Surgery Isahaya General Hospital Isahaya Japan
5. Department of Surgery Sasebo City General Hospital Sasebo Japan
6. Department of Surgery Saiseikai Nagasaki Hospital Nagasaki Japan
Abstract
AbstractObjectivesWe aimed to assess mid‐term outcomes after laparoscopic surgery (LAP) vs open surgery (OP) for pathological T4 (pT4) and/or N2 (pN2) colon cancer.MethodsWe retrospectively reviewed 255 primary tumor resections for pT4 and/or pN2 colon cancer performed from 2015 to 2020 at six hospitals, divided into LAP (n = 204) and OP groups (n = 51). After propensity score matching to minimize selection bias, 47 matched patients per group were assessed.ResultsBefore matching, the rate of males (53.9% vs. 37.3%, P = .042), left sided colon cancer (53.9% vs 37.3%, P = .042), D3 lymph node dissection (90.7% vs 68.6%, P < .001) and body mass index (kg/m2) (22.3 vs 21.8, P = .039) were significantly greater in the LAP group. The rate of pT4b (7.8% vs 40.4%, P < .001) was lower and pN2 was higher (57.4% vs 37.3%, P = .012) in the LAP group. After matching, preoperative characteristics and pathologic status were equivalent between the groups. The LAP and OP groups showed comparable overall survival (OS) (2‐year OS, 84.5% vs 76.8%, P = .055) and recurrence‐free survival (RFS) (2‐year RFS, 73.9% vs 52.8%, P = .359). In the patients with pT4, OS (2‐year OS, 79.4% vs 75.7%, P = .359) and RFS (2‐year RFS, 71.3% vs 58.7%) were comparable. In the patients with pN2, OS (2‐year OS, 83.4% vs 76.3%) and RFS (2‐year RFS, 69.6% vs 36.2%) were also comparable.ConclusionsLAP for pT4 and/or pN2 colon cancer showed comparable mid‐term outcomes compared with OP. LAP was an acceptable surgical approach in this cohort.