A randomized trial of laparoscopic versus open surgery for rectal cancer
- Bonjer H.J.; Deijen C.L.; Abis G.A.; Cuesta M.A.; Van Der Pas M.H.G.M.; De Lange-De Klerk E.S.M.; Lacy A.M.; Bemelman W.A.; Andersson J.; Angenete E.; Rosenberg J.; Fuerst A.; Haglind E.; d'Hoore A.; Birch D.; DeGara C.; Jamieson C.; Peiman P.; Jensen K.J.; Bulut O.; Jess P.; Harvald T.; Ovesen H.; Lundhus E.; Iesalnieks I.; Agha A.; Jaeger C.; Kreis M.; Kasparek M.; Kim S.H.; van der Peet D.; Buunen M.; Hop W.; Neijenhuis P.; Coene P.P.; van der Harst E.; van't Riet Y.; Gerhards M.; Prins H.; Targarona E.; Balague C.; Martinez C.; Osorio J.F.; Molina G.; Delgado S.; Lujan J.; Valero G.; Alonso-Poza A.; Losadar M.; Argudo S.; Lackberg Z.; Skullman S.; Kurlberg G.; Ekelund J.; Kressner U.; Matthiessen P.
- Issue Date
- Massachussetts Medical Society
- New England Journal of Medicine, v.372, no.14, pp.1324 - 1332
- Journal Title
- New England Journal of Medicine
- Start Page
- End Page
- Background: Laparoscopic resection of colorectal cancer is widely used. However, robust evidence to conclude that laparoscopic surgery and open surgery have similar outcomes in rectal cancer is lacking. A trial was designed to compare 3-year rates of cancer recurrence in the pelvic or perineal area (locoregional recurrence) and survival after laparoscopic and open resection of rectal cancer. Methods: In this international trial conducted in 30 hospitals, we randomly assigned patients with a solitary adenocarcinoma of the rectum within 15 cm of the anal verge, not invading adjacent tissues, and without distant metastases to undergo either laparoscopic or open surgery in a 2:1 ratio. The primary end point was locoregional recurrence 3 years after the index surgery. Secondary end points included disease-free and overall survival. Results: A total of 1044 patients were included (699 in the laparoscopic-surgery group and 345 in the open-surgery group). At 3 years, the locoregional recurrence rate was 5.0% in the two groups (difference, 0 percentage points; 90% confidence interval [CI], -2.6 to 2.6). Disease-free survival rates were 74.8% in the laparoscopic-surgery group and 70.8% in the open-surgery group (difference, 4.0 percentage points; 95% CI, -1.9 to 9.9). Overall survival rates were 86.7% in the laparoscopic-surgery group and 83.6% in the open-surgery group (difference, 3.1 percentage points; 95% CI, -1.6 to 7.8). Conclusions: Laparoscopic 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. Copyright © 2015 Massachusetts Medical Society. All rights reserved.
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- 2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles
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