Laparoscopic approach for T4 colon cancer can be associated with poor prognosis in right-sided T4b tumours期刊界 All Journals 搜尽天下杂志传播学术成果专业期刊搜索期刊信息化学术搜索

Laparoscopic approach for T4 colon cancer can be associated with poor prognosis in right-sided T4b tumours

Affiliation:	1. Center for Colorectal Cancer, National Cancer Center, Goyang, Republic of Korea;2. Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea;3. Department of Surgery, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea;4. Department of Surgery, Hallym University College of Medicine, Anyang, Republic of Korea;5. Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea;1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China;2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China;3. Institute of Thoracic Oncology, Fudan University, Shanghai, 200032, China;4. Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, 08903, New Jersey, USA;5. Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China;1. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;2. Department of Gastric Surgery, Liaoning Cancer Hospital and Institute, Cancer Hospital of China Medical University, Shenyang, China;3. Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;4. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China;5. Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union College, Beijing, China;6. Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi’an, China;7. Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;8. Department of Gastrointestinal Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China;9. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China;10. Department of Gastrointestinal Surgery, Peking University People’s Hospital, Beijing, China;11. Department of General Surgery, the First Affiliated Hospital of Shandong First Medical University, Jinan, China;1. Division of Breast Surgery, IEO European Institute of Oncology, IRCCS, Milan, Italy;2. Department of Oncology and Hemato-Oncology, University of Milan, Italy;3. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA;4. Division of Epidemiology and Biostatistics, IEO European Institute of Oncology, IRCCS, Milan, Italy;1. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan;2. Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan;1. University of Edinburgh Medical School, UK;2. Edinburgh Breast Unit, NHS Lothian, UK;3. Department of Radiology, NHS Lothian, UK;4. Department of Haematology, NHS Lothian, UK;5. Edinburgh Cancer Research Centre, University of Edinburgh, UK;1. Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;2. Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;3. Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;4. Department of Radiology, Erasmus MC Cancer Institute, Rotterdam, the Netherlands

Abstract:	IntroductionAlthough recent studies have demonstrated the safety of laparoscopic surgery in T4 colon cancer, some patients could have poor prognosis. In this study, we aimed to analyse the risk factors affecting oncologic outcome of laparoscopic surgery.Materials and methodsAmong the 1033 T4 colon cancer patients collected from a multicentre database (2004–2017), 584 patients (458 T4a and 126 T4b) underwent laparoscopic approach for radical surgery. Risk factors associated with 3-year disease-free survival (DFS) and overall survival (OS) were evaluated through multivariate analysis. In addition, subgroups were classified using a combination of risk factors, and the survival rate was evaluated.ResultsDuring this period, 188 (32.2%) had recurrence, and 151 (25.9%) died. In the multivariate analysis for oncologic outcome, elevated carcinoembryonic antigen level (hazard ratio HR] 1.37) and absence of adjuvant chemotherapy (HR 1.60) were associated with poor DFS. T4b (HR 1.56, 1.46), right-sided location (HR 1.52, 1.42), and open conversion (HR 2.70, 2.12) were independently associated with both poor DFS and OS. When four subgroups were analysed through the combination of tumour location and T stage, the DFS and OS rates were significantly lower in patients with right-sided T4b cancer than in other groups (log-rank p < 0.001).ConclusionRight-sided T4b colon cancer for laparoscopic surgery may lead to poor oncologic outcome. This approach could be a caution in suspected cases preoperatively.

Keywords:	Laparoscopy Oncologic outcomes Tumour location T4 colon cancer AJCC"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"American Joint Committee on Cancer CEA"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"carcinoembryonic antigen CT"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"computed tomography DFS"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"disease-free survival HR"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"hazard ratio LCC"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"left-sided colon cancer MRI"} {"#name":"keyword" "$":{"id":"kwrd0095"} "$$":[{"#name":"text" "_":"magnetic resonance imaging OS"} {"#name":"keyword" "$":{"id":"kwrd0105"} "$$":[{"#name":"text" "_":"overall survival RCC"} {"#name":"keyword" "$":{"id":"kwrd0115"} "$$":[{"#name":"text" "_":"right-sided colon cancer
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