HUSCAP logo Hokkaido Univ. logo

Hokkaido University Collection of Scholarly and Academic Papers >
Graduate School of Medicine / Faculty of Medicine >
Peer-reviewed Journal Articles, etc >

Exploration of the advantages of minimally invasive surgery for clinical T4 colorectal cancer compared with open surgery : A matched-pair analysis

Files in This Item:

The file(s) associated with this item can be obtained from the following URL:

Title: Exploration of the advantages of minimally invasive surgery for clinical T4 colorectal cancer compared with open surgery : A matched-pair analysis
Authors: Imaizumi, Ken Browse this author
Homma, Shigenori Browse this author →KAKEN DB
Miyaoka, Yoichi Browse this author
Matsui, Hiroki Browse this author
Ichikawa, Nobuki Browse this author
Yoshida, Tadashi Browse this author
Takahashi, Norihiko Browse this author
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: chemotherapy
clinical T4
colorectal cancer
minimally invasive surgery
primary tumor resection
Issue Date: 12-Aug-2022
Publisher: Lippincott Williams & Wilkins (LWW)
Journal Title: Medicine
Volume: 101
Issue: 32
Start Page: e29869
Publisher DOI: 10.1097/MD.0000000000029869
Abstract: The indications of minimally invasive surgery (MIS) for T4 colorectal cancer are controversial because the advantages of MIS are unclear. Therefore, we compared overall survival (OS) and recurrence-free survival (RFS) as the primary endpoint, and short-term outcome, alteration in perioperative laboratory data, and the interval of postoperative chemotherapy from operation as secondary endpoints, between MIS and open surgery (OPEN) using a matched-pair analysis. We explored the advantages of MIS for T4 colorectal cancer. In this retrospective single-institution study, we included 125 patients with clinical T4 colorectal cancer who underwent curative-intent surgery of the primary tumor between October 2010 and September 2019. Conversion cases were excluded. MIS patients were matched to OPEN patients (ratio of 1:2) according to tumor location, clinical T stage, and preoperative treatment. We identified 25 and 50 patients who underwent OPEN and MIS, respectively, including 31 with distant metastasis. Both groups had similar background characteristics. The rate of major morbidities (Clavien-Dindo grade > III) was comparable between the 2 groups (P = .597), and there was no mortality in either group. MIS tended to result in shorter postoperative hospitalization than OPEN (P = .073). Perioperative alterations in laboratory data revealed that MIS suppressed surgical invasiveness better compared to OPEN. Postoperative chemotherapy, especially for patients with distant metastasis who underwent primary tumor resection, tended to be started earlier in the MIS group than in the OPEN group (P = .075). OS and RFS were comparable between the 2 groups (P = .996 and .870, respectively). In the multivariate analyses, MIS was not a significant prognostic factor for poor OS and RFS. MIS was surgically safe and showed similar oncological outcomes to OPEN-with the potential of reduced invasiveness and enhanced recovery from surgery. Therefore, patients undergoing MIS might receive subsequent postoperative treatments earlier.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Export metadata:

OAI-PMH ( junii2 , jpcoar_1.0 )

MathJax is now OFF:


 - Hokkaido University