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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Oncologic relevance of magnetic resonance imaging-detected threatened mesorectal fascia for patients with mid or low rectal cancer: A longitudinal analysis before and after long-course, concurrent chemoradiotherapy.
Il Tae Son,Young Hoon Kim,Kyoung Ho Lee,Sung Il Kang,Duck Woo Kim,Eun Shin,Keun Wook Lee,Soyeon Ahn,Jae Sung Kim,Sung Bum Kang +9 more
TL;DR: This study confirms that magnetic resonance Imaging–detected threatened mesorectal fascia predicts poor oncologic outcomes for mid or low rectal cancer and shows that the diagnostic performance of pre‐LCRT magnetic resonance imaging is different from that of post-LCRT Magnetic resonance imaging.
Journal ArticleDOI
Short-term and oncological outcomes of natural orifice specimen extraction surgery (NOSES) for colorectal cancer in China: a national database study of 5055 patients.
Xu Guan,Xiyue Hu,Zhengyi Jiang,Ye Wei,Donghui Sun,Miao-Miao Wu,Hai-xia Zhou,Hongliang Yao,Junmin Song,Guiyu Wang,Jun-hong Hu,Mingyang Ren,Qing Xu,Jian-Chun Cai,Jian Peng,Dan Ma,Yangchun Zheng,Qingsi He,Bo-tao Jiang,Zejun Wang,Taiyuan Li,Su Yan,Luchuan Chen,Tiegang Li,Zhi-Guo Xiong,Pan Chi,Liang Wang,Gang Yu,Xiaofang Deng,Hong Zhang,Ming Xie,Hongyan Gong,Xuejun Sun,Wei-dong Zang,Peng He,Zheng Wen,Chunxu Zhang,Yusheng Wang,Yinggang Chen,Guangwei Xie,Mingzhang Li,Shaojun Yu,Haiyi Liu,Ming-Zhi Pu,Chuan-Gang Fu,Xishan Wang +45 more
Journal ArticleDOI
Short-term and Long-term Outcomes Regarding Laparoscopic Versus Open Surgery for Low Rectal Cancer: A Systematic Review and Meta-Analysis.
TL;DR: The pooled analyses showed, despite longer operation times, that there were significantly less blood loss, fewer transfusions, shorter times to bowel function recovery, resumed diet and hospital durations, and lower overall complication and wound infection rates.
Journal ArticleDOI
The effect of hospital volume on resection margins in rectal cancer surgery
Sarah J. Atkinson,Meghan C. Daly,Emily F. Midura,David A. Etzioni,Daniel E. Abbott,Shimul A. Shah,Bradley R. Davis,Ian M. Paquette +7 more
TL;DR: The results support standardization of surgical technique and pathologic assessment as part of a broader initiative that identifies and refers patients to higher performing hospitals rather than simply to higher volume hospitals.
Journal ArticleDOI
Clinical and oncologic outcomes of laparoscopic versus open surgery in elderly patients with colorectal cancer: a retrospective multicenter study.
TL;DR: In this article, the authors compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery in elderly patients with colorectal cancer in six Hallym University-affiliated hospitals.
References
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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
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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.