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
More filters
Journal ArticleDOI
Guidelines for perioperative care in elective colonic surgery: Enhanced recovery after surgery (ERAS®) society recommendations
Ulf Gustafsson,Michael J. Scott,Michael J. Scott,W. Schwenk,Nicolas Demartines,Didier Roulin,Nader K. Francis,Clare McNaught,John MacFie,A. S. Liberman,Mattias Soop,Andrew G. Hill,Robin H. Kennedy,Dileep N. Lobo,Kenneth C. H. Fearon,Olle Ljungqvist,Olle Ljungqvist +16 more
TL;DR: Based on the evidence available for each item of the multimodal perioperative care pathway, the Enhanced Recovery After Surgery (ERAS) Society, International Association for Surgical Metabolism and Nutrition (IASMEN) and European Society for Clinical Nutrition and Metabolicism (ESPEN) present a comprehensive evidence-based consensus review of peri operative care for colonic surgery.
Journal ArticleDOI
Clinical practice guidelines in oncology
William J. Gradishar,Benjamin O. Anderson,Ron Balassanian,Sarah L. Blair,Harold J. Burstein,Amy E. Cyr,Anthony D. Elias,William B. Farrar,Andres Forero,Sharon H. Giordano,Matthew P. Goetz,Lori J. Goldstein,Steven J. Isakoff,Janice A. Lyons,P. Kelly Marcom,Ingrid A. Mayer,Beryl McCormick,Meena S. Moran,Ruth O'Regan,Sameer A. Patel,Lori J. Pierce,Elizabeth C. Reed,Kilian E. Salerno,Lee S. Schwartzberg,Amy Sitapati,Karen L. Smith,Mary Lou Smith,Hatem Soliman,George Somlo,Melinda L. Telli,John H. Ward,Rashmi Kumar,Dorothy A. Shead +32 more
TL;DR: This manuscript focuses on the NCCN Guidelines Panel recommendations for the workup, primary treatment, risk reduction strategies, and surveillance specific to DCIS.
Journal ArticleDOI
A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer
H. Jaap Bonjer,Charlotte L. Deijen,Gabor S. A. Abis,Miguel A. Cuesta,Lange-de Klerk,Antonio M. Lacy,Willem A. Bemelman,John Andersson,Eva Angenete,Jacob Rosenberg,Alois Fuerst,Eva Haglind +11 more
TL;DR: Laroscopic surgery in patients with rectal cancer was associated with rates of locoregional recurrence and disease-free and overall survival similar to those for open surgery.
Journal ArticleDOI
Effect of Laparoscopic-Assisted Resection vs Open Resection of Stage II or III Rectal Cancer on Pathologic Outcomes: The ACOSOG Z6051 Randomized Clinical Trial
James W. Fleshman,Megan E. Branda,Daniel J. Sargent,Anne Marie Boller,Virgilio George,Maher A. Abbas,Walter R. Peters,Dipen Maun,George J. Chang,Alan J. Herline,Alessandro Fichera,Matthew G. Mutch,Steven D. Wexner,Mark H. Whiteford,John Marks,Elisa H. Birnbaum,David A. Margolin,David W. Larson,Peter W. Marcello,Mitchell C. Posner,Thomas E. Read,John R. T. Monson,Sherry M. Wren,Peter W.T. Pisters,Heidi Nelson +24 more
TL;DR: Among patients with stage II or III rectal cancer, the use of laparoscopic resection compared with open resection failed to meet the criterion for noninferiority for pathologic outcomes.
Journal ArticleDOI
Effect of Laparoscopic-Assisted Resection vs Open Resection on Pathological Outcomes in Rectal Cancer: The ALaCaRT Randomized Clinical Trial
Andrew R. L. Stevenson,Andrew R. L. Stevenson,Michael J. Solomon,John W. Lumley,Peter J. Hewett,Andrew D. Clouston,Andrew D. Clouston,Val Gebski,Lucy Claire Davies,Kate Wilson,Wendy Hague,John Simes +11 more
TL;DR: Among patients with T1-T3 rectal tumors, noninferiority of laparoscopic surgery compared with open surgery for successful resection was not established, and these findings do not provide sufficient evidence for the routine use of lapARoscopic surgery.
References
More filters
Journal ArticleDOI
Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial
Martijn H G M van der Pas,Eva Haglind,Miguel A. Cuesta,Alois Fürst,Antonio M. Lacy,Wim C. J. Hop,Hendrik J. Bonjer +6 more
TL;DR: In selected patients with rectal cancer treated by skilled surgeons, laparoscopic surgery resulted in similar safety, resection margins, and completeness of resection to that of open surgery, and recovery was improved after laparoscope surgery.
Journal ArticleDOI
Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial.
M. Buunen,R. Veldkamp,Wim C. J. Hop,Esther Kuhry,Johannes Jeekel,Eva Haglind,Lars Påhlman,Miguel A. Cuesta,Simon Msika,Mario Morino,Antonio M. Lacy,Hendrik J. Bonjer +11 more
TL;DR: The trial could not rule out a difference in disease-free survival at 3 years in favour of open colectomy because the upper limit of the 95% CI for the difference just exceeded the predetermined non-inferiority boundary of 7%, but, it believes, clinically acceptable, justifying the implementation of laparoscopic surgery into daily practice.
Journal ArticleDOI
Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial.
Sung Bum Kang,Ji Won Park,Seung-Yong Jeong,Byung-Ho Nam,Hyo Seong Choi,Duck-Woo Kim,Seok-Byung Lim,Taek-Gu Lee,Dae Yong Kim,Jae Sung Kim,Hee Jin Chang,Hye Seung Lee,Sun Young Kim,Kyung Hae Jung,Yong Sang Hong,Jee Hyun Kim,Dae Kyung Sohn,Dae-Hyun Kim,Jae Hwan Oh +18 more
TL;DR: The laparoscopic surgery group showed earlier recovery of bowel function than the open surgery group, and Involvement of the circumferential resection margin, macroscopic quality of the total mesorectal excision specimen, and perioperative morbidity did not differ between the two groups.
Journal ArticleDOI
The construction and testing of the EORTC colorectal cancer-specific quality of life questionnaire module (QLQ-CR38)
TL;DR: Results lend support to the clinical validity of the QLQ-CR38 as a supplementary questionnaire for assessing specific QL issues relevant to patients with colorectal cancer.
Journal ArticleDOI
Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer
TL;DR: This study compared surgical outcomes after laparoscopic and open approaches for mid and low rectal cancers in men and women with confirmed or suspected rectal cancer.