Department of Gastroenterological Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
Department of Surgery, Gastroenterological Center, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Surg Endosc. 2017 Oct;31(10):3890-3897. doi: 10.1007/s00464-017-5418-z. Epub 2017 Feb 15.
Laparoscopic surgery has been widely accepted for the treatment of colorectal cancer; however, long-term outcomes in elderly patients remain controversial. The midterm results of a randomized trial comparing open surgery with laparoscopic surgery in elderly patients with colorectal cancer are presented.
This was a randomized trial comparing open surgery with laparoscopic surgery in elderly patients with colorectal cancer. The primary outcome was complication rate, and secondary outcomes included 3-year recurrence-free survival and overall survival. A total of 200 patients were randomly assigned to open surgery or laparoscopic surgery between 2008 and 2012. The main study objective was to compare the midterm outcomes of open surgery with those of laparoscopic surgery in elderly patients with colorectal cancer. This trial is registered with Clinical Trials.gov (NCT01862562).
There were no differences between the laparoscopic surgery group and open surgery group in the 3-year overall survival rate (91.5% for laparoscopic surgery vs. 90.6% for open surgery, p = 0.638) or the 3-year recurrence-free survival rate (84.8% for laparoscopic surgery vs. 88.2% for open surgery, p = 0.324). The local recurrence rate was significantly higher in the laparoscopic surgery group than in the open surgery group in rectal cancer (13.8% for laparoscopic surgery vs. 0% for open surgery, p = 0.038). In subgroup analysis according to tumor location, there were no significant differences in the 3-year overall survival rate or 3-year recurrence-free survival rate between the two treatment groups.
The midterm outcomes of laparoscopic surgery are similar to those of open surgery in elderly patients with colorectal cancer.
腹腔镜手术已被广泛接受用于治疗结直肠癌；然而，老年患者的长期结果仍存在争议。本文介绍了一项比较腹腔镜手术与开腹手术治疗老年结直肠癌患者的随机试验的中期结果。
这是一项比较腹腔镜手术与开腹手术治疗老年结直肠癌患者的随机试验。主要结局是并发症发生率，次要结局包括 3 年无复发生存率和总生存率。2008 年至 2012 年间，共有 200 名患者被随机分配至开腹手术或腹腔镜手术组。主要研究目的是比较腹腔镜手术与开腹手术治疗老年结直肠癌患者的中期结果。本试验在 ClinicalTrials.gov 注册（NCT01862562）。
腹腔镜手术组与开腹手术组在 3 年总生存率（腹腔镜手术组为 91.5%，开腹手术组为 90.6%，p=0.638）或 3 年无复发生存率（腹腔镜手术组为 84.8%，开腹手术组为 88.2%，p=0.324）方面无差异。在直肠癌患者中，腹腔镜手术组的局部复发率明显高于开腹手术组（腹腔镜手术组为 13.8%，开腹手术组为 0%，p=0.038）。根据肿瘤位置进行亚组分析，两组患者的 3 年总生存率或 3 年无复发生存率无显著差异。
腹腔镜手术在老年结直肠癌患者中的中期结果与开腹手术相似。
