Background:Laparoscopic surgery for rectal cancer is commonly performed in China.However,compared with open surgery,the effectiveness of laparoscopic surgery,especially the long-term survival,has not been sufficiently...Background:Laparoscopic surgery for rectal cancer is commonly performed in China.However,compared with open surgery,the effectiveness of laparoscopic surgery,especially the long-term survival,has not been sufficiently proved.Methods:Data of eligible patients with non-metastatic rectal cancer at Nanfang Hospital of Southern Medical University and Guangdong Provincial Hospital of Chinese Medicine between 2012 and 2014 were retrospectively reviewed.Long-termsurvival outcomes and short-termsurgical safety were analysed with propensity score matching between groups.Results:Of 430 cases collated from two institutes,103 matched pairs were analysed after propensity score matching.The estimated blood loss during laparoscopic surgerywas significantly less than that during open surgery(P=0.019)and the operative time and hospital staywere shorter in the laparoscopic group(both P<0.001).The post-operative complications ratewas 9.7%in the laparoscopic group and 10.7%in the open group(P=0.818).No significant differencewas observed between the laparoscopic group and the open group in the 5-year overall survival rate(75.7%vs 80.6%,P=0.346),5-year relapse-free survival rate(74.8%vs 76.7%,P=0.527),or 5-year cancer-specific survival rate(79.6%vs 87.4%,P=0.219).An elevated carcinoembryonic antigen,<12 harvested lymph nodes,and perineural invasion were independent prognostic factors affecting overall survival and relapse-free survival.Conclusions:Our findings suggest that open surgery should still be the priority recommendation,but laparoscopic surgery is also an acceptable treatment for non-metastatic rectal cancer.展开更多
基金supported by clinical research of Guangdong Provincial Hospital of Chinese Medicine[No.YN10101902]a scientific research project of Guangdong Provincial Academy of Chinese Medical Sciences[No.YN2018ML11].
文摘Background:Laparoscopic surgery for rectal cancer is commonly performed in China.However,compared with open surgery,the effectiveness of laparoscopic surgery,especially the long-term survival,has not been sufficiently proved.Methods:Data of eligible patients with non-metastatic rectal cancer at Nanfang Hospital of Southern Medical University and Guangdong Provincial Hospital of Chinese Medicine between 2012 and 2014 were retrospectively reviewed.Long-termsurvival outcomes and short-termsurgical safety were analysed with propensity score matching between groups.Results:Of 430 cases collated from two institutes,103 matched pairs were analysed after propensity score matching.The estimated blood loss during laparoscopic surgerywas significantly less than that during open surgery(P=0.019)and the operative time and hospital staywere shorter in the laparoscopic group(both P<0.001).The post-operative complications ratewas 9.7%in the laparoscopic group and 10.7%in the open group(P=0.818).No significant differencewas observed between the laparoscopic group and the open group in the 5-year overall survival rate(75.7%vs 80.6%,P=0.346),5-year relapse-free survival rate(74.8%vs 76.7%,P=0.527),or 5-year cancer-specific survival rate(79.6%vs 87.4%,P=0.219).An elevated carcinoembryonic antigen,<12 harvested lymph nodes,and perineural invasion were independent prognostic factors affecting overall survival and relapse-free survival.Conclusions:Our findings suggest that open surgery should still be the priority recommendation,but laparoscopic surgery is also an acceptable treatment for non-metastatic rectal cancer.
