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: | Julien Taieb, Eloy Espin, Rea Lo Dico, Weitz Jürgen, Côme Lepage, Thibault Voron, Mehdi Karoui, Antoine Cazelles, Richard Douard, Alexis Buggenhout, Karine Le Malicot, F. Denimal, Matthieu Bruzzi, Fabio Cianchi |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Laparoscopic surgery medicine.medical_specialty Organoplatinum Compounds Colorectal cancer medicine.medical_treatment Leucovorin Cetuximab Antineoplastic Agents Disease-Free Survival law.invention 03 medical and health sciences 0302 clinical medicine FOLFOX Randomized controlled trial law Antineoplastic Combined Chemotherapy Protocols medicine Humans Stage (cooking) Propensity Score Laparoscopy Colectomy Aged Neoplasm Staging Hepatology medicine.diagnostic_test business.industry Gastroenterology Prognosis medicine.disease Surgery Europe Survival Rate Clinical trial Treatment Outcome 030220 oncology & carcinogenesis Colonic Neoplasms Multivariate Analysis Female 030211 gastroenterology & hepatology Fluorouracil business Follow-Up Studies medicine.drug |
| Zdroj: | Digestive and Liver Disease. 53:1034-1040 |
| ISSN: | 1590-8658 |
| DOI: | 10.1016/j.dld.2021.05.012 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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