Comparative study of oncologic efficacy of cephalomedial to lateral dissection versus medial to lateral dissection in laparoscopic total mesorectal excision for rectal cancer: An RCT study
| Autor: | Lu Zang, Ai-Guo Lu, Bi-Yun Qian, Jing Sun, Minhua Zheng, Min Zhong, Ming-Liang Wang, Bo Feng, Xuan Zhao, Hiju Hong, Li Xie, Zheng-Jun Qiu, Chaoran Yu, Feng Dong, Abe Fingerhut, Min-Hao Yu, Junjun Ma |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Disease-Free Survival law.invention 03 medical and health sciences Young Adult 0302 clinical medicine Randomized controlled trial law Clinical endpoint Medicine Humans Postoperative Period Prospective Studies Stage (cooking) Aged Neoplasm Staging Aged 80 and over Proctectomy business.industry Rectal Neoplasms Postoperative complication General Medicine Middle Aged medicine.disease Total mesorectal excision Surgery Dissection Treatment Outcome Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female Laparoscopy Lymph business Follow-Up Studies |
| Zdroj: | Journal of surgical oncologyREFERENCES. 123 |
| ISSN: | 1096-9098 |
| Popis: | Background and objectives We compared the 3-year overall survival between cephalomedial-to-lateral approach proctectomy (CEMP) and medial-to-lateral approach proctectomy (MAP) in patients undergoing laparoscopic total mesorectal excision for rectal cancer. The advantages of CEMP and the clinical value of No. 253 lymph nodes resection have not been objectively analyzed in literature. Methods This was a prospective, two-arm, multicenter, single-blinded, randomized trial. The primary endpoint was 3-year overall survival, and secondary endpoints included safety, feasibility, oncological radicality (including number of No. 253 lymph nodes harvested), short-term outcome, 3-year disease-free survival, rate of postoperative complications, mortality, and rate of recurrence. Results From May 2016 to July 2020, 506 patients were enrolled-256 in the CEMP group and 250 in the MAP group. Comparison of overall survival and disease-free survival showed that there was treatment benefit in the CEMP group (28.22 ± 12.12 vs. 27.44 ± 13.06, p = 0.485; 27.24 ± 12.01 vs. 26.42 ± 12.81; p = 0.457). More No. 253 lymph nodes were harvested in the CEMP group, and cases with positive No. 253 lymph nodes had worse prognosis in stage III. Surgical safety was equal for both approaches. Conclusions Dissection of No. 253 lymph nodes may be important to improve clinical prognosis, but further studies with larger samples are needed to confirm this finding. |
| Databáze: | OpenAIRE |
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