The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer

被引：560

作者：

Lacy, Antonio M. ^{[1
]}

Delgado, Salvadora ^{[1
]}

Castells, Antoni ^{[2
,3
]}

Prins, Hubert A. ^{[1
]}

Arroyo, Vicente ^{[2
,3
]}

Ibarzabal, Ainitze ^{[1
]}

Pique, Josep M. ^{[2
,3
]}

机构：

[1] Univ Barcelona, Hosp Clin, Dept Surg, E-08036 Barcelona, Spain

[2] Univ Barcelona, Hosp Clin, Dept Gastroenterol, E-08036 Barcelona, Spain

[3] Univ Barcelona, Hosp Clin, Ctr Invest Biomed Esther Koplowitz, IMDiM,IDIBAPS, E-08036 Barcelona, Spain

来源：

ANNALS OF SURGERY | 2008年 / 248卷 / 01期

关键词：

D O I：

10.1097/SLA.0b013e31816a9d65

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Objective: The aim of this study was to compare the long-term outcome of laparoscopy-assisted colectomy (LAC) and open colectorny (OC) for nonnietastatic colon cancer. Methods: From November 1993 to July 1998 all patients with adenocarcinoma of the colon were assessed for entry in this single center, clinically randomized trial. Adjuvant therapy and postoperative follow-Lip were similar in both groups. The primary endpoint was cancer-related survival and secondary endpoints were probability of overall survival and probability of being free of recurrence, Data were analyzed according the intention-to-treat principle. Results: Two hundred and nineteen patients entered the study (111 LAC group and 108 OC group). The median follow-up was 95 months (range, 77-133). There was a tendency of higher cancer-related survival (P = 0.07, NS) and overall survival (P = 0.06, NS) for the LAC group. Probability of cancer-related survival was higher in the LAC group (P = 0.02) when compared with OC. The regression analysis showed that LAC was independently associated with a reduced risk of tumor relapse (hazard ratio 0.47, 95% Cl 0.23-0.94), death from a cancer-related cause (0.44, 0.21-0.92) and death from any cause (0.59, 0.35-0.98). Conclusions: LAC is more effective than OC in the treatment of colon cancer.

引用

页码：1 / 7

页数：7

共 31 条

[1] Increased tumor establishment and growth after open vs laparoscopic surgery in mice may be related to differences in postoperative T-cell function [J].

Allendorf, JDF ;

Bessler, M ;

Horvath, KD ;

Marvin, MR ;

Laird, DA ;

Whelan, RL .

SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES, 1999, 13 (03) :233-235

[2] Major abdominal surgery increases plasma levels of vascular endothelial growth factor - Open more so than minimally invasive methods [J].

Belizon, Avraham ;

Balik, Emre ;

Feingold, Daniel L. ;

Bessler, Marc ;

Arnell, Tracey D. ;

Forde, Kenneth A. ;

Horst, Patrick K. ;

Jain, Suvinit ;

Cekic, Vesna ;

Kirman, Irena ;

Whelan, Richard L. .

ANNALS OF SURGERY, 2006, 244 (05) :792-798

[3] Laparoscopic-assisted vs. open colectomy for colorectal cancer:: Influence on neoplastic cell mobilization [J].

Bessa, X ;

Castells, A ;

Lacy, AM ;

Elizalde, JI ;

Delgado, S ;

Boix, L ;

Piñol, V ;

Pellisé, M ;

García-Valdecasas, JC ;

Piqué, JM .

JOURNAL OF GASTROINTESTINAL SURGERY, 2001, 5 (01) :66-73

[4] Surgeon volume and operative mortality in the United States [J].

Birkmeyer, JD ;

Stukel, TA ;

Siewers, AE ;

Goodney, PP ;

Wennberg, DE ;

Lucas, FL .

NEW ENGLAND JOURNAL OF MEDICINE, 2003, 349 (22) :2117-2127

[5] Laparoscopic surgery versus open surgery for colon cancer:: short-term outcomes of a randomised trial [J].

Bonjer, HJ ;

Haglind, E ;

Jeekel, I ;

Kazemier, G ;

Páhlman, L ;

Hop, WCJ ;

Veldkamp, R ;

Kuhry, E ;

Haglind, E ;

Pahlman, L ;

Cuesta, MA ;

Msika, S ;

Morino, M ;

Lacy, A ;

Jeekel, I .

LANCET ONCOLOGY, 2005, 6 (07) :477-484

[6] Impact of hospital case volume on short-term outcome after laparoscopic operation for colonic cancer [J].

Bonjer, HJ ;

Haglind, E ;

Jeekel, J ;

Kazemier, G ;

Pahlman, L ;

Monson, JRT ;

Quircke, P ;

Trede, M ;

Stijnen, T ;

Kuhry, E ;

Hop, WCJ ;

Veldkamp, R ;

Cuesta, MA ;

Jeckel, J ;

Morino, M ;

Lacy, A ;

Delgado, S ;

Wittich, P ;

Hazebroek, E ;

Gholghesaei, M ;

Hellberg, R ;

Nordgren, SR ;

Lindgren, PG ;

Lindholm, E ;

Dahlberg, M ;

Raab, Y ;

Anderberg, B ;

Ewerth, S ;

Janson, M ;

Åkerlund, JE ;

Smedh, K ;

Montgomery, A ;

Skullman, S ;

Nyström, PO ;

Kald, A ;

Wärnström, A ;

Dàlen, J ;

Svedberg, I ;

Edlund, G ;

Kressner, U ;

Öberg, A ;

Lundberg, O ;

Lindmark, GE ;

Heikkinen, T ;

Morino, M ;

Giraudo, G ;

Lacy, A ;

Delgado, S ;

Sanz, EM ;

Diez, JM .

SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2005, 19 (05) :687-692

[7] Laparoscopic-assisted cecectomy is associated with decreased formation of postoperative pulmonary metastases compared with open cecectomy in a murine model [J].

Carter, JJ ;

Feingold, DL ;

Kirman, I ;

Oh, A ;

Wildbrett, P ;

Asi, Z ;

Fowler, R ;

Huang, E ;

Whelan, RL .

SURGERY, 2003, 134 (03) :432-436

[8]

Chen Wen, 2007, Zhongguo Zhong Xi Yi Jie He Za Zhi, V27, P127

[9] Acute phase response in laparoscopic and open colectomy in colon cancer -: Randomized study [J].

Delgado, S ;

Lacy, AM ;

Filella, X ;

Castells, A ;

García-Valdecasas, JC ;

Pique, JM ;

Momblán, D ;

Visa, J .

DISEASES OF THE COLON & RECTUM, 2001, 44 (05) :638-646

[10]

EGGERMONT AMM, 1987, SURGERY, V102, P71

← 1 2 3 4 →