AI Article Synopsis
- The study compares laparoscopic resection (LR) and open resection (OR) methods in middle-aged patients with colorectal cancer (CRC) to determine survival outcomes.
- After analyzing data from 2009 to 2017 using propensity score matching, the results showed that LR led to significantly better 5-year overall survival (OS) and disease-free survival (DFS) compared to OR.
- Key findings indicate that LR is associated with improved survival rates for Stage II and III diseases, with similar complication rates but advantages like less blood loss and shorter hospital stays.
Article Abstract
Background: The prognosis of middle-aged patients with colorectal cancer (CRC) treated by laparoscopic resection (LR) is unclear. This study aimed to evaluate the survival outcomes of LR compared with open resection (OR) for middle-aged patients with CRC.
Patients And Methods: This retrospective cohort study used the data from a database of all consecutive colorectal resections performed between January 2009 and December 2017. Propensity score matching (PSM) was performed to handle the selection bias based on age, gender, body mass index, tumour location, AJCC stage and admission year. Univariate and multivariate COX regression model was used to identify risk factors of overall survival (OS) and disease-free survival (DFS).
Results: After PSM, 154 patients were included in each group. Compared with the OR group in the total cohort, there were better survival outcomes in the LR group for 5-year OS and 5-year DFS (both P < 0.001). These differences were observed for Stage II and III diseases and for all CRC, irrespective of location. The multivariate analysis showed that tumour ≥5 cm (hazard ratio [HR] = 1.750, 95% confidence interval [CI]: 1.026-2.986, P = 0.040), Stage III (HR = 14.092, 95% CI: 1.894-104.848, P = 0.010) and LR (HR = 0.300, 95% CI: 0.160-0.560, P < 0.001) were independently associated with OS. Pre-operative carcinoembryonic antigen ≥5 ng/ml (HR = 3.954, 95% CI: 1.363-11.473, P = 0.011), Stage III (HR = 6.206, 95% CI: 1.470-26.200, P = 0.013) and LR (HR = 0.341, 95% CI: 0.178-0.653, P = 0.001) were independently associated with DFS.
Conclusions: In middle-aged patients with CRC, LR achieves better survival than OR. Complications are similar, except for less blood loss and shorter post-surgical hospital stay with LR.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10246648 | PMC |
| http://dx.doi.org/10.4103/jmas.jmas_81_22 | DOI Listing |
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