Efficacy and safety of laparoscopic resection of colorectal cancer in non-elite cases

Abstract

Purpose: To evaluate the outcomes of laparoscopic resection of colorectal cancer in non-elite cases.

Methods: We defined patients whose clinical characteristics conformed to the criteria of the JCOG0404 trial as "elite" and those whose clinical characteristics did not conform to these criteria as "non-elite". Patients with Stage II/III colorectal cancer (n = 450) were analyzed. The elite (E) and non-elite (NE) groups were further divided into open (E-Open, NE-Open) and laparoscopic (E-Lap, NE-Lap) surgery groups. We compared the short- and long-term outcomes of these groups. Propensity score matching (PSM) was performed when comparing the NE groups.

Results: The E group included 163 patients and the NE group included 287 patients. Before and after PSM, the NE-Lap group had significantly longer operative times, lower postoperative complication rates, earlier recovery of bowel function, and shorter postoperative hospital stays than the NE-Open group. After PSM, the Clavien-Dindo classification Grade ≥ III complications and reoperation rates in the NE-Lap group were significantly lower than those in the NE-Open group. The short-term outcomes of the NE-Lap group were comparable with those of the E-Lap group. The 5-year overall survival rates were not significantly different among the groups.

Conclusion: Laparoscopic resection of colorectal cancer is effective and safe, even in non-elite cases.

Keywords: Colorectal cancer; Laparoscopic surgery; Matched-Pair Analysis; Non-elite patient; Propensity score.