Early results of laparoscopic surgery for colorectal cancer - Retrospective analysis of 372 patients treated by clinical outcomes of Surgical Therapy (Cost) Study Group

James W. Fleshman, Heidi Nelson, Walter R. Peters, H. Charles Kim, Sergio Larach, Richard R. Boorse, Wayne Ambroze, Phillip Leggett, Ronald Bleday, Steven Stryker, Brent Christenson, Steven Wexner, Anthony Senagore, David Rattner, John Sutton, Arthur P. Fine

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Abstract

PURPOSE: This study was undertaken to determine the early experience of the embers of the COST Study Group with colorectal cancer treated by laparoscopic approaches. METHOD: A retrospective review was performed of all patients with colorectal cancer treated with laparoscopy by the COST Study Group before August 1994. Tumor site, stage, differentiation, procedure completion, presence of recurrence (local, distant, trocar site), and cause of death were analyzed. RESULTS: A total of 372 patients with adenocarcinoma of the colon and rectum were treated by laparoscopic approach between October 1991 and August 1994 (170 men and 192 women): right colectomy, 170; sigmoid colectomy, 55; low anterior resection, 56; abdominoperineal resection, 44; left colectomy, 22; colostomy, 8; total colectomy, 6; transverse colectomy, 7; exploration, 2. Conversion to an open procedure was required in 15.6 percent of cases. Operative mortality was 2 percent. Tumor characteristics were as follows: TNM state: I, 40 percent; II, 25 percent; III, 18 percent; IV, 17 percent; Differentiation: well-moderate, 88 percent; poor, 12 percent; carcinomatosis, 5 percent. Local (3.6 percent) and distant implantation occurred in four patients (1.1 percent). Only one of these patients died a cancer-related death (Stage III at 36 months). Cancer-related death rates increased with increasing stage of tumor: I, -4 percent; II, 17 percent; III, 31 percent; IV, 70 percent. CONCLUSION: A laparoscopic approach to colorectal cancer results in early outcome after treatment that is comparable with conventional therapy for colorectal cancer. A randomized trial is needed to compare long-term outcomes of open and laparoscopic approaches with colorectal cancer.

Original languageEnglish (US)
JournalDiseases of the Colon and Rectum
Volume39
Issue number10 Supplement
DOIs
StatePublished - Oct 1996
Externally publishedYes

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Colectomy
Group Psychotherapy
Laparoscopy
Colorectal Neoplasms
Neoplasms
Conversion to Open Surgery
Women's Rights
Colostomy
Mortality
Sigmoid Colon
Rectum
Surgical Instruments
Cause of Death
Colon
Adenocarcinoma
Carcinoma
Recurrence

Keywords

  • Cancer
  • Laparoscopic colectomy
  • Recurrence

ASJC Scopus subject areas

  • Gastroenterology

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Early results of laparoscopic surgery for colorectal cancer - Retrospective analysis of 372 patients treated by clinical outcomes of Surgical Therapy (Cost) Study Group. / Fleshman, James W.; Nelson, Heidi; Peters, Walter R.; Kim, H. Charles; Larach, Sergio; Boorse, Richard R.; Ambroze, Wayne; Leggett, Phillip; Bleday, Ronald; Stryker, Steven; Christenson, Brent; Wexner, Steven; Senagore, Anthony; Rattner, David; Sutton, John; Fine, Arthur P.

In: Diseases of the Colon and Rectum, Vol. 39, No. 10 Supplement, 10.1996.

Research output: Contribution to journalArticle

Fleshman, JW, Nelson, H, Peters, WR, Kim, HC, Larach, S, Boorse, RR, Ambroze, W, Leggett, P, Bleday, R, Stryker, S, Christenson, B, Wexner, S, Senagore, A, Rattner, D, Sutton, J & Fine, AP 1996, 'Early results of laparoscopic surgery for colorectal cancer - Retrospective analysis of 372 patients treated by clinical outcomes of Surgical Therapy (Cost) Study Group', Diseases of the Colon and Rectum, vol. 39, no. 10 Supplement. https://doi.org/10.1007/BF02053806
Fleshman, James W. ; Nelson, Heidi ; Peters, Walter R. ; Kim, H. Charles ; Larach, Sergio ; Boorse, Richard R. ; Ambroze, Wayne ; Leggett, Phillip ; Bleday, Ronald ; Stryker, Steven ; Christenson, Brent ; Wexner, Steven ; Senagore, Anthony ; Rattner, David ; Sutton, John ; Fine, Arthur P. / Early results of laparoscopic surgery for colorectal cancer - Retrospective analysis of 372 patients treated by clinical outcomes of Surgical Therapy (Cost) Study Group. In: Diseases of the Colon and Rectum. 1996 ; Vol. 39, No. 10 Supplement.
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abstract = "PURPOSE: This study was undertaken to determine the early experience of the embers of the COST Study Group with colorectal cancer treated by laparoscopic approaches. METHOD: A retrospective review was performed of all patients with colorectal cancer treated with laparoscopy by the COST Study Group before August 1994. Tumor site, stage, differentiation, procedure completion, presence of recurrence (local, distant, trocar site), and cause of death were analyzed. RESULTS: A total of 372 patients with adenocarcinoma of the colon and rectum were treated by laparoscopic approach between October 1991 and August 1994 (170 men and 192 women): right colectomy, 170; sigmoid colectomy, 55; low anterior resection, 56; abdominoperineal resection, 44; left colectomy, 22; colostomy, 8; total colectomy, 6; transverse colectomy, 7; exploration, 2. Conversion to an open procedure was required in 15.6 percent of cases. Operative mortality was 2 percent. Tumor characteristics were as follows: TNM state: I, 40 percent; II, 25 percent; III, 18 percent; IV, 17 percent; Differentiation: well-moderate, 88 percent; poor, 12 percent; carcinomatosis, 5 percent. Local (3.6 percent) and distant implantation occurred in four patients (1.1 percent). Only one of these patients died a cancer-related death (Stage III at 36 months). Cancer-related death rates increased with increasing stage of tumor: I, -4 percent; II, 17 percent; III, 31 percent; IV, 70 percent. CONCLUSION: A laparoscopic approach to colorectal cancer results in early outcome after treatment that is comparable with conventional therapy for colorectal cancer. A randomized trial is needed to compare long-term outcomes of open and laparoscopic approaches with colorectal cancer.",
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AU - Fleshman, James W.

AU - Nelson, Heidi

AU - Peters, Walter R.

AU - Kim, H. Charles

AU - Larach, Sergio

AU - Boorse, Richard R.

AU - Ambroze, Wayne

AU - Leggett, Phillip

AU - Bleday, Ronald

AU - Stryker, Steven

AU - Christenson, Brent

AU - Wexner, Steven

AU - Senagore, Anthony

AU - Rattner, David

AU - Sutton, John

AU - Fine, Arthur P.

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N2 - PURPOSE: This study was undertaken to determine the early experience of the embers of the COST Study Group with colorectal cancer treated by laparoscopic approaches. METHOD: A retrospective review was performed of all patients with colorectal cancer treated with laparoscopy by the COST Study Group before August 1994. Tumor site, stage, differentiation, procedure completion, presence of recurrence (local, distant, trocar site), and cause of death were analyzed. RESULTS: A total of 372 patients with adenocarcinoma of the colon and rectum were treated by laparoscopic approach between October 1991 and August 1994 (170 men and 192 women): right colectomy, 170; sigmoid colectomy, 55; low anterior resection, 56; abdominoperineal resection, 44; left colectomy, 22; colostomy, 8; total colectomy, 6; transverse colectomy, 7; exploration, 2. Conversion to an open procedure was required in 15.6 percent of cases. Operative mortality was 2 percent. Tumor characteristics were as follows: TNM state: I, 40 percent; II, 25 percent; III, 18 percent; IV, 17 percent; Differentiation: well-moderate, 88 percent; poor, 12 percent; carcinomatosis, 5 percent. Local (3.6 percent) and distant implantation occurred in four patients (1.1 percent). Only one of these patients died a cancer-related death (Stage III at 36 months). Cancer-related death rates increased with increasing stage of tumor: I, -4 percent; II, 17 percent; III, 31 percent; IV, 70 percent. CONCLUSION: A laparoscopic approach to colorectal cancer results in early outcome after treatment that is comparable with conventional therapy for colorectal cancer. A randomized trial is needed to compare long-term outcomes of open and laparoscopic approaches with colorectal cancer.

AB - PURPOSE: This study was undertaken to determine the early experience of the embers of the COST Study Group with colorectal cancer treated by laparoscopic approaches. METHOD: A retrospective review was performed of all patients with colorectal cancer treated with laparoscopy by the COST Study Group before August 1994. Tumor site, stage, differentiation, procedure completion, presence of recurrence (local, distant, trocar site), and cause of death were analyzed. RESULTS: A total of 372 patients with adenocarcinoma of the colon and rectum were treated by laparoscopic approach between October 1991 and August 1994 (170 men and 192 women): right colectomy, 170; sigmoid colectomy, 55; low anterior resection, 56; abdominoperineal resection, 44; left colectomy, 22; colostomy, 8; total colectomy, 6; transverse colectomy, 7; exploration, 2. Conversion to an open procedure was required in 15.6 percent of cases. Operative mortality was 2 percent. Tumor characteristics were as follows: TNM state: I, 40 percent; II, 25 percent; III, 18 percent; IV, 17 percent; Differentiation: well-moderate, 88 percent; poor, 12 percent; carcinomatosis, 5 percent. Local (3.6 percent) and distant implantation occurred in four patients (1.1 percent). Only one of these patients died a cancer-related death (Stage III at 36 months). Cancer-related death rates increased with increasing stage of tumor: I, -4 percent; II, 17 percent; III, 31 percent; IV, 70 percent. CONCLUSION: A laparoscopic approach to colorectal cancer results in early outcome after treatment that is comparable with conventional therapy for colorectal cancer. A randomized trial is needed to compare long-term outcomes of open and laparoscopic approaches with colorectal cancer.

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KW - Laparoscopic colectomy

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