Journal ArticleDOI
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.
Seung-Yong Jeong,Seung-Yong Jeong,Ji Won Park,Ji Won Park,Byung-Ho Nam,Sohee Kim,Sung Bum Kang,Seok Byung Lim,Hyo Seong Choi,Duck Woo Kim,Hee Jin Chang,Dae Yong Kim,Kyung Hae Jung,Tae You Kim,Gyeong Hoon Kang,Eui Kyu Chie,Sun-Young Kim,Dae Kyung Sohn,Dae-Hyun Kim,Jae Sung Kim,Hye Seung Lee,Jee Hyun Kim,Jae Hwan Oh +22 more
TLDR
The results show that laparoscopic resection for locally advanced rectal cancer after preoperative chemoradiotherapy provides similar outcomes for disease-free survival as open resection, thus justifying its use.Abstract:
Summary Background Compared with open resection, laparoscopic resection of rectal cancers is associated with improved short-term outcomes, but high-level evidence showing similar long-term outcomes is scarce. We aimed to compare survival outcomes of laparoscopic surgery with open surgery for patients with mid-rectal or low-rectal cancer. Methods The Comparison of Open versus laparoscopic surgery for mid or low REctal cancer After Neoadjuvant chemoradiotherapy (COREAN) trial was an open-label, non-inferiority, randomised controlled trial done between April 4, 2006, and Aug 26, 2009, at three centres in Korea. Patients (aged 18–80 years) with cT3N0–2M0 mid-rectal or low-rectal cancer who had received preoperative chemoradiotherapy were randomly assigned (1:1) to receive either open or laparoscopic surgery. Randomisation was stratified by sex and preoperative chemotherapy regimen. Investigators were masked to the randomisation sequence; patients and clinicians were not masked to the treatment assignments. The primary endpoint was 3 year disease-free survival, with a non-inferiority margin of 15%. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00470951. Findings We randomly assigned 340 patients to receive either open surgery (n=170) or laparoscopic surgery (n=170). 3 year disease-free survival was 72·5% (95% CI 65·0–78·6) for the open surgery group and 79·2% (72·3–84·6) for the laparoscopic surgery group, with a difference that was lower than the prespecified non-inferiority margin (–6·7%, 95% CI −15·8 to 2·4; p Interpretation Our results show that laparoscopic resection for locally advanced rectal cancer after preoperative chemoradiotherapy provides similar outcomes for disease-free survival as open resection, thus justifying its use. Funding National Cancer Center, South Korea.read more
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Response assessment of locally advanced rectal cancer after neoadjuvant chemoradiotherapy: Is apparent diffusion coefficient useful on 3 T magnetic resonance imaging?
Piero Boraschi,Rosa Cervelli,Francescamaria Donati,Elena Landi,Andrea Cacciato-Insilla,Daniela Campani,Davide Caramella +6 more
TL;DR: In this paper , the diagnostic value of apparent diffusion coefficient (ADC) on 3 T device for the prediction of tumoral response to neoadjuvant chemoradiotherapy (nCRT) and for the response assessment after nCRT in patients with locally advanced rectal cancer (LARC), using pathology as a reference.
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Double-stapled anastomosis without “dog-ears” reduces the anastomotic leakage in laparoscopic anterior resection of rectal cancer: A prospective, randomized, controlled study
TL;DR: In this paper , the authors investigated whether the resection of "dog-ears" in laparoscopic anterior resection (called modified double-stapling technique, MDST) could reduce the rate of postoperative morbidity and mortality in the treatment of colorectal cancer.
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Robotic surgery for locally advanced T4 rectal cancer: feasibility and oncological quality
Marcos Gómez Ruiz,R. Ballestero Diego,Patricia Tejedor,C. Cagigas Fernández,L. Cristobal Poch,Natalia Suárez Pazos,J. Castillo Diego +6 more
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Analysis of bowel function, urogenital function, and long-term follow-up outcomes associated with robotic and laparoscopic sphincter-preserving surgical approaches to total mesorectal excision in low rectal cancer: a retrospective cohort study
TL;DR: In this article , the authors analyzed short-term clinical effectiveness and long-term follow-up endpoints associated with robotic-assisted sphincter-preserving surgery (RAS) and laparoscopic-assisted SpHpreserving Surgery (LAS) when used to treat low rectal cancer.
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Robotic versus laparoscopic proctectomy: A comparative study of short-term economic and clinical outcomes
TL;DR: In this article , the authors compared the financial and clinical outcomes of robotic and laparoscopic proctectomy within a public healthcare system, and found that a robotic approach was associated with a lower conversion rate (2.5% versus 21.8%) at the expense of longer operating times (284±83.4 versus 243±89.8 minutes).
References
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Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer
Rolf Sauer,Heinz Becker,Werner Hohenberger,Claus Rödel,Christian Wittekind,Rainer Fietkau,Peter Martus,Jörg Tschmelitsch,Eva Hager,Clemens F. Hess,Torsten Liersch,Heinz Schmidberger,Rudolf Raab +12 more
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A comparison of laparoscopically assisted and open colectomy for colon cancer.
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Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial
Pierre J. Guillou,Philip Quirke,H. Thorpe,J. Walker,David G. Jayne,Adrian Smith,Richard M. Heath,Julia Brown +7 more
TL;DR: Laroscopic-assisted surgery for cancer of the colon is as effective as open surgery in the short term and is likely to produce similar long-term outcomes, however, impaired short- term outcomes after laparosc-assisted anterior resection forcancer of the rectum do not yet justify its routine use.
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Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial
Antonio M. Lacy,Juan Carlos García-Valdecasas,Salvadora Delgado,Antoni Castells,Pilar Taura,Josep M. Piqué,Josep Visa +6 more
TL;DR: LAC is more effective than OC for treatment of colon cancer in terms of morbidity, hospital stay, tumour recurrence, and cancer-related survival.
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Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group.
David G. Jayne,Pierre J. Guillou,H. Thorpe,Philip Quirke,Joanne Copeland,Adrian Smith,Richard M. Heath,Julia Brown +7 more
TL;DR: Long-term outcomes for patients with rectal cancer were similar in those undergoing abdominoperineal resection and AR, and support the continued use of laparoscopic surgery in these patients.