TY - JOUR
T1 - A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer
AU - Bonjer, H. Jaap
AU - Deijen, Charlotte L.
AU - Abis, Gabor A.
AU - Cuesta, Miguel A.
AU - van der Pas, Martijn H. G. M.
AU - de Lange-de Klerk, Elly S. M.
AU - Lacy, Antonio M.
AU - Bemelman, Willem A.
AU - Andersson, John
AU - Angenete, Eva
AU - Rosenberg, Jacob
AU - Fuerst, Alois
AU - Haglind, Eva
AU - AUTHOR GROUP
AU - D'Hoore, André
AU - Birch, Dan
AU - DeGara, Chris
AU - Jamieson, Chris
AU - Peiman, Poornoroozy
AU - Jensen, Karl Juul
AU - Bulut, Orhan
AU - Jess, Per
AU - Harvald, Thomas
AU - Ovesen, Henrik
AU - Lundhus, Eskilde
AU - Iesalnieks, Igors
AU - Agha, Ayman
AU - Jaeger, Christina
AU - Kreis, Martin
AU - Kasparek, Michael
AU - Kim, Seon Hahn
AU - Bonjer, Jaap
AU - Cuesta, Miguel
AU - van der Peet, Donald
AU - Buunen, Mark
AU - van der Pas, Martijn
AU - Abis, Gabor
AU - Deijen, Charlotte
AU - de Lange-de Klerk, Elly
AU - Hop, Wim
AU - Neijenhuis, Peter
AU - Coene, Peter Paul
AU - van der Harst, Erwin
AU - van 't Riet, Yvonne
AU - Gerhards, Michael
AU - Prins, Hubert
AU - Targarona, Eduardo
AU - Balague, Carmen
AU - Martinez, Carmen
AU - Osorio, Juan Franco
AU - Molina, García
PY - 2015
Y1 - 2015
N2 - BACKGROUND Laparoscopic resection of colorectal cancer is widely used. However, robust evidence to conclude that laparoscopic surgery and open surgery have similar outcomes in rectal cancer is lacking. A trial was designed to compare 3-year rates of cancer recurrence in the pelvic or perineal area (locoregional recurrence) and survival after laparoscopic and open resection of rectal cancer. METHODS In this international trial conducted in 30 hospitals, we randomly assigned patients with a solitary adenocarcinoma of the rectum within 15 cm of the anal verge, not invading adjacent tissues, and without distant metastases to undergo either laparoscopic or open surgery in a 2: 1 ratio. The primary end point was locoregional recurrence 3 years after the index surgery. Secondary end points included disease-free and overall survival. RESULTS A total of 1044 patients were included (699 in the laparoscopic-surgery group and 345 in the open-surgery group). At 3 years, the locoregional recurrence rate was 5.0% in the two groups (difference, 0 percentage points; 90% confidence interval [CI], -2.6 to 2.6). Disease-free survival rates were 74.8% in the laparoscopic-surgery group and 70.8% in the open-surgery group (difference, 4.0 percentage points; 95% CI, -1.9 to 9.9). Overall survival rates were 86.7% in the laparoscopic-surgery group and 83.6% in the open-surgery group (difference, 3.1 percentage points; 95% CI, -1.6 to 7.8). CONCLUSIONS Laparoscopic surgery in patients with rectal cancer was associated with rates of locoregional recurrence and disease-free and overall survival similar to those for open surgery
AB - BACKGROUND Laparoscopic resection of colorectal cancer is widely used. However, robust evidence to conclude that laparoscopic surgery and open surgery have similar outcomes in rectal cancer is lacking. A trial was designed to compare 3-year rates of cancer recurrence in the pelvic or perineal area (locoregional recurrence) and survival after laparoscopic and open resection of rectal cancer. METHODS In this international trial conducted in 30 hospitals, we randomly assigned patients with a solitary adenocarcinoma of the rectum within 15 cm of the anal verge, not invading adjacent tissues, and without distant metastases to undergo either laparoscopic or open surgery in a 2: 1 ratio. The primary end point was locoregional recurrence 3 years after the index surgery. Secondary end points included disease-free and overall survival. RESULTS A total of 1044 patients were included (699 in the laparoscopic-surgery group and 345 in the open-surgery group). At 3 years, the locoregional recurrence rate was 5.0% in the two groups (difference, 0 percentage points; 90% confidence interval [CI], -2.6 to 2.6). Disease-free survival rates were 74.8% in the laparoscopic-surgery group and 70.8% in the open-surgery group (difference, 4.0 percentage points; 95% CI, -1.9 to 9.9). Overall survival rates were 86.7% in the laparoscopic-surgery group and 83.6% in the open-surgery group (difference, 3.1 percentage points; 95% CI, -1.6 to 7.8). CONCLUSIONS Laparoscopic surgery in patients with rectal cancer was associated with rates of locoregional recurrence and disease-free and overall survival similar to those for open surgery
U2 - https://doi.org/10.1056/NEJMoa1414882
DO - https://doi.org/10.1056/NEJMoa1414882
M3 - Article
C2 - 25830422
SN - 0028-4793
VL - 372
SP - 1324
EP - 1332
JO - New England journal of medicine
JF - New England journal of medicine
IS - 14
ER -