Short- and long-term outcomes following laparoscopic palliative resection for patients with incurable, asymptomatic stage IV colorectal cancer: A multicenter study in Japan
ORIGINAL RESEARCH ARTICLE
Tomonori Akagi1), Masafumi Inomata1), Suguru Hasegawa2), Yousuke Kinjo2), Masaaki Ito3), Yosuke Fukunaga4), Akiyoshi Kanazawa5), Hitoshi Idani6), Seiichiro Yamamoto7), Koki Otsuka8), Shungo Endo9), Masahiko Watanabe10) , Japan Society of Laparoscopic Colorectal Surgery
1) Department of Gastroenterological & Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan 2) Department of Surgery, Kyoto University, Kyoto, Japan 3) Department of Colorectal and Pelvic Surgery, National Cancer Center Hospital East, Chiba, Japan 4) Department of Gastroenterological Surgery, Cancer Institute Hospital, Tokyo, Japan 5) Department of Gastroenterology, Osaka Red Cross Hospital, Osaka, Japan 6) Department of Surgery, Fukuyama City Hospital, Fukuyama, Japan 7) Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan 8) Department of Surgery, Iwate Medical University, Iwate, Japan 9) Department of Surgery, Showa University School of Medicine, Yokohama Northern Hospital, Yokohama, Japan 10) Department of Surgery, Kitasato University, Sagamihara, Japan
Objective: This retrospective multicenter study compared short- and long-term results between Japanese patients with asymptomatic stage IV colorectal cancer who underwent palliative laparoscopic surgery (LS) versus those who underwent conventional open surgery (OS). Methods: Among 968 patients treated for stage IV colorectal cancer from January 2006 to December 2007 in 41 surgical units that were participating in the Japan Society of Laparoscopic Colorectal Surgery group, we studied 398 patients who received palliative resection of their asymptomatic primary colorectal tumor. Results: We analyzed data from patients undergoing LS (LS group, n=106) and OS (OS group, n=292). Fourteen (13.2%) LS group patients were converted to OS. Although the differences between groups for postoperative complications were not significant, the mean time to solid food intake and postoperative length of hospital stay for the LS group were significantly shorter than those for the OS group (2 vs. 3 days, p<0.0001; 13 vs. 16 days, p<0.0001, respectively). The LS group patients experienced a longer median survival time than that of the OS group (24.5 vs. 23.9 months, p=0.0357). Conclusions: Laparoscopic palliative resection (LS) offers advantages for short-term outcomes and no disadvantages for long-term outcomes. The use of laparoscopic procedures to treat asymptomatic, incurable stage IV colorectal cancer appears to be acceptable.
October 30, 2017; doi: dx.doi.org/10.23922/jarc.2017-012