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
Citations
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Transanal total mesorectal excision assisted by single-port laparoscopic surgery for low rectal cancer.
TL;DR: TaTME assisted by abdominal single-port may be safely achieved in selected rectal cancer patients, and none of the patients suffered from fecal incontinence after ileostomy closure.
Journal ArticleDOI
Is the laparoscopic approach for rectal cancer superior to open surgery? A systematic review and meta-analysis on short-term surgical outcomes.
Piotr Małczak,Magdalena Mizera,Grzegorz Torbicz,Jan Witowski,Piotr Major,Magdalena Pisarska,Michał Wysocki,Marcin Strzałka,Andrzej Budzyński,Michał Pędziwiatr +9 more
TL;DR: A systematic review based on available RCTs confirms that laparoscopic rectal cancer surgery is associated with short-term outcomes comparable to the open approach, and in some aspects it provides better results.
Journal ArticleDOI
2D versus 3D laparoscopic total mesorectal excision: a developmental multicentre randomised controlled trial.
Nathan J Curtis,Nathan J Curtis,John A. Conti,Richard Dalton,Timothy Rockall,Timothy Rockall,A. S. Allison,Jonathan Ockrim,Iain Jourdan,Jared Torkington,Stephen Phillips,J. Allison,George B. Hanna,Nader K. Francis,Nader K. Francis +14 more
TL;DR: 3D imaging did not alter the number of intraoperative adverse events; however, a potential improvement in mesorectal specimen quality was observed and should form the focus of future 3D laparoscopic TME trials.
Journal ArticleDOI
Laparoscopic Surgery for Colorectal Cancer in Korea: Nationwide Data from 2013 to 2018
TL;DR: The laparoscopic penetration rate for CRC in Korea continued to increase annually and reached 78.5% in 2018, and a steady increase in the number of patients undergoing surgery for CRC was observed over 80 years of age.
Journal ArticleDOI
Surgical approach for rectal cancer: A network meta-analysis comparing open, laparoscopic, robotic and transanal TME approaches
O K Ryan,Éanna J Ryan,Ben Creavin,Emanuele Rausa,Michael E. Kelly,Fausto Petrelli,Gianluca Bonitta,Rory Kennelly,Ann M. Hanly,Sean T. Martin,Des C. Winter +10 more
TL;DR: While OpTME was the most effective TME modality for short term histopathological resection quality, there was no difference in long-term oncologic outcomes.
References
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Journal ArticleDOI
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
TL;DR: Preoperative chemoradiotherapy, as compared with postoperative cheMoradi therapy, improved local control and was associated with reduced toxicity but did not improve overall survival.
Journal ArticleDOI
A comparison of laparoscopically assisted and open colectomy for colon cancer.
Heidi Nelson,Daniel J. Sargent,H Sam Wieand,James W. Fleshman,Mehran Anvari,Steven J. Stryker,Robert W. Beart,Michael D. Hellinger,Richard Flanagan,Walter R. Peters,David M. Ota +10 more
TL;DR: In this multi-institutional study, the rates of recurrent cancer were similar after laparoscopically assisted colectomy and open-colectomy, suggesting that the laparoscopic approach is an acceptable alternative to open surgery for colon cancer.
Journal ArticleDOI
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.
Journal ArticleDOI
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.
Journal ArticleDOI
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.