Keywords
Open Curative Excision
Rectal Cancer
Survival after Rectal Cancer
Categories
How to Cite
Abstract
Background: Management of rectal cancer has been evolved over the past two decades with the introduction of total mesorectal excision (TME) and laparoscopic resection. Objective: This study aims to assess the difference in the long-term outcomes after laparoscopic and open resection for potentially curable, non-metastatic rectal cancer patients.
Methods: This is a retrospective study which has been conducted in a single tertiary care center where the patients were recruited from the colorectal database of the Section of Colon and Rectal Surgery at King Faisal Specialist Hospital & Research Centre (KFSH&RC). It included all the patients who had non-metastatic rectal cancer and underwent laparoscopic or open curative resection regardless of their age or the comorbid status during the period from January 2012 – December 2015. We studied the long-term outcomes for those patients which included the completeness of resection of the tumor, overall 3-year survival, 3-year disease-free survival, local recurrence, and distal recurrence of cancer.
Results:120 patients were included in this study, 69 of them were males and 51 were females. 86 (71.7%) of them underwent open surgery while 34 (28.3%) underwent laparoscopic surgery. After a mean follow-up of 32.4 months: 104 patients were alive, 7 deceased, and 9 were lost of follow-up. Local recurrence in the open approach (OA), and laparoscopic approach (LA) groups was 3/86 (3.5%) and 4/34 (11.8%) respectively. Distal recurrence occurred in 12/86 (14%) of OA and 5/34 (14.7%) of LA. Overall 3-years survival for OA and LA was 89% and 97% respectively and the 3-years disease-free survival was 49% and 57% respectively.
Conclusion: Laparoscopic and open rectal excision were similar in their outcome.
References
Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MHGM, de Lange-de Klerk ESM, et al. A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer. N Engl J Med. 2015 Apr 2; 372(14):1324–32. https://doi.org/10.1056/nejmoa1414882
van der Pas M, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WCJ, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): Short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013 Mar; 14(3):210–8. https://doi.org/10.1016/s1470-2045(13)70016-0
Boller AM, Nelson H. Colon and Rectal Cancer: Laparoscopic or Open? Clin Cancer Res. 2007 Nov 15; 13(22 Pt 2): 6894s-6s. https://doi.org/10.1158/1078-0432.ccr-07-1138
Green BL, Marshall HC, Collinson F, Quirke P, Guillou P, Jayne DG, et al. Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg. 2013 Jan; 100(1):75–82. https://doi.org/10.1002/bjs.8945
Li S, Jiang F, Tu J, Zheng X. Long-term Oncologic Outcomes of Laparoscopic versus Open Surgery for Middle and Lower Rectal Cancer. PLoS One. 2015 Sep 3, 10(9): e0135884. https://doi.org/10.1371/journal.pone.0135884
Alsanea N, Almadi MA, Abduljabbar AS, Alhomoud S, Alshaban TA, Alsuhaibani A, et al. National Guidelines for Colorectal Cancer Screening in Saudi Arabia with strength of recommendations and quality of evidence. Ann Saudi Med. May-Jun 2015; 35(3):189–95. https://doi.org/10.5144/0256-4947.2015.189
Bazarbashi SN, Alzahrani AM, Rahal MM, Al-Shehri AS, Aljubran AH, Alsanea NA, et al. Saudi Oncology Society clinical management guideline series. Colorectal cancer 2014. Saudi Med J. 2014 Dec; 35(12):1538–44.
National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology. Rectal Cancer. 2017.
Jeong SY, Park JW, Nam BH, Kim S, Kang SB, Lim SB, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): Survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol. 2014 Jun; 15(7):767-74. https://doi.org/10.1016/s1470-2045(14)70205-0
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2020 Turki Alshammari et al.
