Abstract
Background
This study aimed to review the outcomes of laparoscopic colorectal resection for patients with stage IV colorectal cancer.
Methods
From the prospectively collected database for patients who underwent surgery for colorectal cancer in our institution, those with stage IV colorectal cancer who underwent elective resection of tumor during the period from January 2000 to June 2006 were included. The outcomes of those with laparoscopic resection were reviewed and comparison was made between patients with laparoscopic and open resection.
Results
A total of 200 patients (127 men) with median age of 69 years (range: 25–91 years) were included, and 77 underwent laparoscopic resection. Conversion was required in ten patients (13.0%) and all except one conversion were due to fixed or bulky tumors. There was no operative mortality in the laparoscopic group. The complication rate was 14% and the median postoperative hospital stay was 7 days. When patients with laparoscopic resection were compared with those with open operations, there was no difference in age, gender, comorbidity, or tumor size between the two groups. However, the complication rate was significantly lower in those with laparoscopic resection (14% versus 32%, P = 0.007) and the median hospital stay was significantly shorter (7 days versus 8 days, P = 0.005).The operative mortalities and the survivals were similar in the two groups.
Conclusions
Colorectal resection can be performed safely in patients with stage IV colorectal cancer. The operative outcomes in terms of complication rate and hospital stay compare favorably with patients with open resection.
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References
Cook AD, Single R, McCahill LE Surgical resection of primary tumors in patients who present with stage IV colorectal cancer: an analysis of surveillance, epidemiology, and end results data, 1988 to 2000 Ann Surg Oncol 2005; 12:637–45
Choti MA, Sitzmann JV, Tiburi MF, et al. Trends in long-term survival following liver resection for hepatic colorectal metastases Ann Surg 2002; 235:759–66
Abdalla EK, Vauthey JN, Ellis LM, et al. Recurrence and outcomes following hepatic resection, radiofrequency ablation, and combined resection/ablation for colorectal liver metastases Ann Surg 2004; 239:818–25
Fong Y, Fortner J, Sun RL, et al. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases Ann Surg 1999; 230:309–18
Vogelsang H, Haas S, Hierholzer C, et al. Factors influencing survival after resection of pulmonary metastases from colorectal cancer Br J Surg 2004; 91:1066–71
Scoggins CR, Meszoely IM, Blanke CD, et al. Nonoperative management of primary colorectal cancer in patients with stage IV disease Ann Surg Oncol 1999; 6:651–7
Michel P, Roque I, Di Fiore F, et al. Colorectal cancer with non-resectable synchronous metastases: should the primary tumor be resected? Gastroenterol Clin Biol 2004; 28:434–7
Liu SK, Church JM, Lavery IC, et al. Operation in patients with incurable colon cancer–is it worthwhile? Dis Colon Rectum 1997; 40:11–14
Takaki HS, Ujiki GT, Shields TS Palliative resections in the treatment of primary colorectal cancer Am J Surg 1977; 133:548–50
A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004; 350:2050–9
Leung KL, Kwok SP, Lam SC, et al. Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial Lancet 2004; 363:1187–92
Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial Lancet 2002; 359:2224–9
Moloo H, Bedard EL, Poulin EC, et al. Palliative laparoscopic resections for Stage IV colorectal cancer Dis Colon Rectum 2006; 49:213–18
Milsom JW, Kim SH, Hammerhofer KA, et al. Laparoscopic colorectal cancer surgery for palliation Dis Colon Rectum 2000; 43:1512–16
Gonzalez R, Smith CD, Ritter EM, et al. Laparoscopic palliative surgery for complicated colorectal cancer Surg Endosc 2005;19:43–6
Law WL, Lee YM, Choi HK, et al. Laparoscopic and open anterior resection for upper and mid rectal cancer: an evaluation of outcomes Dis Colon Rectum 2006; 49:1108–15
Law WL, Lee YM, Choi HK, et al. Impact of laparoscopic resection for colorectal cancer on operative outcomes and survival Ann Surg 2007; 245:1–7
Martin R, Paty P, Fong Y, et al. Simultaneous liver and colorectal resections are safe for synchronous colorectal liver metastasis J Am Coll Surg 2003; 197:233–41
Ruo L, Gougoutas C, Paty PB, et al. Elective bowel resection for incurable stage IV colorectal cancer: prognostic variables for asymptomatic patients J Am Coll Surg 2003; 196:722–8
Konyalian VR, Rosing DK, Haukoos JS, et al. The role of primary tumour resection in patients with stage IV colorectal cancer Colorectal Dis 2007; 9:430–7
Law WL, Chan WF, Lee YM, et al. Non-curative surgery for colorectal cancer: critical appraisal of outcomes Int J Colorectal Dis 2004; 19:197–202
Makela J, Haukipuro K, Laitinen S, et al. Palliative operations for colorectal cancer Dis Colon Rectum 1990; 33:846–50
Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial Lancet 2002; 359:2224–9
Poulin EC, Mamazza J, Schlachta CM, et al. Laparoscopic resection does not adversely affect early survival curves in patients undergoing surgery for colorectal adenocarcinoma Ann Surg 1999; 229:487–92
Law WL, Chu KW, Tung PH Laparoscopic colorectal resection: a safe option for elderly patients J Am Coll Surg 2002; 195:768–73
Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial Lancet 2005; 365:1718–26
Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial Lancet Oncol 2005; 6:477–84
Casillas S, Delaney CP, Senagore AJ, et al. Does conversion of a laparoscopic colectomy adversely affect patient outcome? Dis Colon Rectum 2004; 47:1680–5
Gonzalez R, Smith CD, Mason E, et al. Consequences of conversion in laparoscopic colorectal surgery Dis Colon Rectum 2006; 49:197–204
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Presented in the Scientific Meeting of the Society of American Gastrointestinal and Endoscopic Surgeons on 18–22 April 2007 in Las Vegas, Nevada, USA.
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Lun Law, W., Fan, J.K.M., Poon, J.T.C. et al. Laparoscopic Bowel Resection in the Setting of Metastatic Colorectal Cancer. Ann Surg Oncol 15, 1424–1428 (2008). https://doi.org/10.1245/s10434-008-9820-6
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DOI: https://doi.org/10.1245/s10434-008-9820-6