Impact of laparoscopy on oncological outcomes after colectomy for stage III colon cancer: A post-hoc multivariate analysis from PETACC8 European randomized clinical trial.

Autor: Voron T; Sorbonne Université, Department of Digestive and General Surgery, Saint Antoine Hospital, Paris, France., Karoui M; Université de Paris, Department of General and Digestive Surgery, Georges Pompidou European Hospital, AP-HP, Paris, France. Electronic address: mehdi.karoui@aphp.fr., Lo Dico R; Université de Paris, Department of Digestive Surgery, Saint Louis Hospital, AP-HP, Paris, France., Malicot KL; Fédération Francophone de Cancérologie Digestive, Faculty of Medecine, Dijon, France; EPICAD INSERM UMR LNC 1231, University of Burgundy Franche Comté, Dijon France., Espin E; Department of General Surgery, Hospital Valle de Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain., Cianchi F; Department of Surgery and Translational Medicine, University of Florence, Florence, Italy., Jürgen W; Department of Visceral, Thoracic and Vascular surgery, University Hospital Carl Gustav Carus of the Technical University Dresden, Germany., Buggenhout A; Department of surgical gastroenterology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium., Bruzzi M; Université de Paris, Department of General and Digestive Surgery, Georges Pompidou European Hospital, AP-HP, Paris, France., Denimal F; Department of Digestive Surgery, Centre Hospitalier Départemental Vendée, La Roche sur Yon, France., Cazelles A; Université de Paris, Department of General and Digestive Surgery, Georges Pompidou European Hospital, AP-HP, Paris, France., Douard R; Université de Paris, Department of General and Digestive Surgery, Georges Pompidou European Hospital, AP-HP, Paris, France., Lepage C; EPICAD INSERM UMR LNC 1231, University of Burgundy Franche Comté, Dijon France; HepatoGastroenterology and Digestive oncology department, University hospital Dijon, University of Burgundy and Franche Comté, FFCD, EPICAD INSERM LNC-UMR 1231, Dijon, France., Taieb J; Université de Paris, Department of Digestive Oncology, Georges Pompidou European Hospital, AP-HP, Paris, France.
Jazyk: angličtina
Zdroj: Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2021 Aug; Vol. 53 (8), pp. 1034-1040. Date of Electronic Publication: 2021 Jun 08.
DOI: 10.1016/j.dld.2021.05.012
Abstrakt: Background: In colon cancer (CC), surgery remains the mainstay of treatment with curative intent. Despite several clinical trials comparing open and laparoscopic approaches, data on long-term outcomes for stage III CC are lacking.
Methods: This post-hoc analysis of the European PETACC8 randomized phase 3 trial included patients from 340 sites between December 2005 and November 2009, with long follow-up (median 7.56 years). Patients were randomly assigned to FOLFOX or FOLFOX+cetuximab after colonic resection. The surgical approach was left to the referring surgeon's discretion.
Results: Among 2555 patients included, 1796 (70.29%) were operated on by open surgery and 759 (29.71%) by laparoscopy. The 5-year OS rate was better after laparoscopic resection (85.4%, 95%CI 82.5-87.7) than after open surgery (80.2%, 95%CI 78.2-82.0; p = 0.002). The 5-year DFS rate was also better after laparoscopy (p = 0.016). However, in multivariate analysis using a propensity matching, the surgical approach was not found to be an independent prognostic factor for OS or DFS. OS (p = 0.0243) and DFS (p = 0.035) were increased after laparoscopic surgery in KRAS/BRAF WT sub-group CONCLUSION: We showed that laparoscopic resection has comparable long-term outcomes to open surgery in patients with stage III CC. For those with RAS and BRAF WT CC, laparoscopic colectomy may favorably impact survival.
Competing Interests: Declaration of Competing Interest The authors have no conflict of interest for the present manuscript.
(Copyright © 2021. Published by Elsevier Ltd.)
Databáze: MEDLINE
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