Recurrence kinetics after laparoscopic versus open surgery in colon cancer. A meta-analysis

Ross Lilley, Evangeline Chan, Nicklaus Ng, Amber Orr, Marcin Szostok, Gloria Ting Ting Yeh, Ross Tulloch, George Ramsay, Zhirajr Mokini, Patrice Forget*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Colorectal cancer (CRC) is a leading cause of mortality worldwide and in the UK. Surgical resection is the main curative treatment modality available and using a laparoscopic vs. an open approach may have a direct influence on the inflammatory response, influencing cancer biology and potentially the recurrence kinetics by promoting cancer growth. Methods: This systematic review aims to compare laparoscopic with open surgery for the treatment of colon cancer with a specific focus on the moment of the recurrence. We included randomised controlled trials in intended curative surgery for colon cancer in adults. Interventions: Studies investigating laparoscopic vs. open resection as an intended curative treatment for patients with confirmed carcinoma of the colon. The two co-primary outcomes were the time to recurrence and the overall survival (OS) and disease-free survival (DFS) at three and five years. Meta-analyses were done on the mean differences. Results: After selection, we reviewed ten randomised controlled trials. Most of the trials did not display a statistically significant difference in either DFS or OS at three or at five years when comparing laparoscopic to open surgery. Groups did not differ for the OS and DFS, especially regarding the time needed to observe the median recurrence rate. The quality of evidence (GRADE) was moderate to very low. Conclusion: We observed no difference in the recurrence kinetics, OS or DFS at three or five years when comparing laparoscopic to open surgery in colon cancer.

Original languageEnglish
Article number4163
Number of pages14
JournalJournal of Clinical Medicine
Volume10
Issue number18
Early online date15 Sep 2021
DOIs
Publication statusPublished - Sep 2021

Keywords

  • Colon cancer
  • Laparoscopic surgery
  • Meta-analysis
  • Open surgery
  • Recurrence kinetics

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