Minimally invasive versus open total mesorectal excision for rectal cancer

Long-term results from a case-matched study of 633 patients

Min Soo Cho, Chang Woo Kim, Se-Jin Baek, Hyuk Hur, Byung Soh Min, Seung Hyuk Baik, Kang Young Lee, Nam Kyu Kim

Research output: Contribution to journalArticle

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Abstract

Background This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME. Methods This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment. Results A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0% [MIS]; 17.0% [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0% [MIS]; 5.0% [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4% vs 85.3%, P = .23; disease-specific survival = 88.8% vs 87.4%, P = .53, disease-free survival = 80.7% vs 78.4%, P = .74; local recurrence = 5.7% vs 5.1%, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups. Conclusion We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications.

Original languageEnglish
Article number4055
Pages (from-to)1121-1129
Number of pages9
JournalSurgery (United States)
Volume157
Issue number6
DOIs
Publication statusPublished - 2015 Jun 1
Externally publishedYes

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Minimally Invasive Surgical Procedures
Rectal Neoplasms
Survival
Disease-Free Survival
Pyridinolcarbamate
Recurrence
Neoadjuvant Therapy
Robotics
Case-Control Studies
Neoplasms
Body Mass Index
Research Design
Neoplasm Metastasis

ASJC Scopus subject areas

  • Surgery

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Minimally invasive versus open total mesorectal excision for rectal cancer : Long-term results from a case-matched study of 633 patients. / Cho, Min Soo; Kim, Chang Woo; Baek, Se-Jin; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Lee, Kang Young; Kim, Nam Kyu.

In: Surgery (United States), Vol. 157, No. 6, 4055, 01.06.2015, p. 1121-1129.

Research output: Contribution to journalArticle

Cho, Min Soo ; Kim, Chang Woo ; Baek, Se-Jin ; Hur, Hyuk ; Min, Byung Soh ; Baik, Seung Hyuk ; Lee, Kang Young ; Kim, Nam Kyu. / Minimally invasive versus open total mesorectal excision for rectal cancer : Long-term results from a case-matched study of 633 patients. In: Surgery (United States). 2015 ; Vol. 157, No. 6. pp. 1121-1129.
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abstract = "Background This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME. Methods This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment. Results A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0{\%} [MIS]; 17.0{\%} [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0{\%} [MIS]; 5.0{\%} [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4{\%} vs 85.3{\%}, P = .23; disease-specific survival = 88.8{\%} vs 87.4{\%}, P = .53, disease-free survival = 80.7{\%} vs 78.4{\%}, P = .74; local recurrence = 5.7{\%} vs 5.1{\%}, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups. Conclusion We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications.",
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T1 - Minimally invasive versus open total mesorectal excision for rectal cancer

T2 - Long-term results from a case-matched study of 633 patients

AU - Cho, Min Soo

AU - Kim, Chang Woo

AU - Baek, Se-Jin

AU - Hur, Hyuk

AU - Min, Byung Soh

AU - Baik, Seung Hyuk

AU - Lee, Kang Young

AU - Kim, Nam Kyu

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Background This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME. Methods This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment. Results A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0% [MIS]; 17.0% [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0% [MIS]; 5.0% [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4% vs 85.3%, P = .23; disease-specific survival = 88.8% vs 87.4%, P = .53, disease-free survival = 80.7% vs 78.4%, P = .74; local recurrence = 5.7% vs 5.1%, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups. Conclusion We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications.

AB - Background This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME. Methods This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment. Results A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0% [MIS]; 17.0% [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0% [MIS]; 5.0% [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4% vs 85.3%, P = .23; disease-specific survival = 88.8% vs 87.4%, P = .53, disease-free survival = 80.7% vs 78.4%, P = .74; local recurrence = 5.7% vs 5.1%, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups. Conclusion We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications.

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