Propensity Score-Matched Analysis of Laparoscopic versus Open Surgery for Non-Metastatic Rectal Cancer.
Asian Pac J Cancer Prev
; 22(12): 3967-3975, 2021 Dec 01.
Article
en En
| MEDLINE
| ID: mdl-34967578
ABSTRACT
BACKGROUND:
Rectal cancer is a pervasive type of malignancy that accounts for one-third of colorectal cancers worldwide. Several studies have assessed the use of laparoscopic surgery as a treatment option. However, there is an ongoing debate regarding its oncological safety.METHODS:
This retrospective study included 270 patients with non-metastatic rectal cancer who underwent either laparoscopic resection (LR, n = 93) or open resection (OR, n = 177) in an academic medical center. The primary outcomes were overall survival (OS) and disease-free survival (DFS), whereas the secondary outcome was postoperative complications. We performed propensity score analyses and compared outcomes. Univariate survival analyses using Kaplan-Meier plots and Cox proportional hazard regression models were also conducted.RESULTS:
In the propensity score matching analyses, 93 LR- and 93 OR-matched patients were compared. The overall median follow-up time was 3.95 years (range, 1.98â5.55 years). The 3-year OS was similar between the groups (LR 79.1% vs OR 79.2%, p = 0.82). Meanwhile, the DFS rate was also comparable between the groups (LR 77.8% vs OR 73.2%, p = 0.53). No significant differences in operative blood loss or hospital stay between the groups were observed (150 vs 150 mL, p = 0.74; 9 vs 10 days, p = 0.077, respectively). Also, no difference was found in postoperative complications between the groups (p = 0.23). However, LR was associated with a longer operative time than OR (455 vs 356 min, p < 0.001) and the number of lymph nodes harvested in LR was slightly fewer than OR (10 vs 11, p = 0.045).CONCLUSION:
LR of rectal cancer is safe, feasible, and comparable to standard OR in terms of the oncologic outcomes. However, LR required longer operative times. A well-designed prospective study with a large number of participants and long follow-up period is needed to show significant differences between the two groups..
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
/
Laparoscopía
/
Proctectomía
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Año:
2021
Tipo del documento:
Article