A propensity-score-matched analysis of laparoscopic vs open surgery for rectal cancer in a population-based study / P. Manchon-Walsh, L. Aliste, S. Biondo, E. Espin, M. Pera, E. Targarona, N. Pallarès, R. Vernet, J. A. Espinàs, A. Guarga, J. M. Borràs

Abstract Aim The oncological risk/benefit trade‐off for laparoscopy in rectal cancer is controversial. Our aim was to compare laparoscopic vs open surgery for resection of rectal cancer, using unselected data from the public healthcare system of Catalonia (Spain). Methods This was a multicentre retr...

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Detalhes bibliográficos
Autores: Manchon-Walsh, Paula,, 0000-0001-9089-0577, Aliste Sánchez, Luisa, 0000-0003-0683-1713, Biondo, Sebastián, Espin, Eloy,, 0000-0002-9139-4548, Pera Román, Miguel, 0000-0001-7764-6481, Targarona, Eduardo M., Pallarès, Natàlia,, 0000-0002-1462-379X, Vernet Bellet, Raül,, 0000-0002-1964-6974, Espinàs Piñol, Josep Alfons, 0000-0002-4027-7114, Guarga, Alex, 0009-0009-8817-3152, Borràs Andrés, Josep Maria,, 0000-0001-7330-6308, EUIT, Institut d'Investigació Biomèdica de Bellvitge
Formato: artículo
Fecha de publicación:2018
País:España
Recursos:Universitat de Girona (UdG)
Repositorio:DDEUIT. Dipòsit Digital de l'Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa
OAI Identifier:DIPOSIT-EUIT:56305
Acesso em linha:https://biblioteca.euit.fdsll.cat/cgi-bin/koha/opac-detail.pl?biblionumber=56305
Access Level:acceso abierto
Palavra-chave:Càncer de recte
Laparoscòpia
Cirurgia
Professors
Càncer colorectal
Colorectal cancer
Laparoscopy
Surgery
Statistics
Spain
Catalonia
Descrição
Resumo:Abstract Aim The oncological risk/benefit trade‐off for laparoscopy in rectal cancer is controversial. Our aim was to compare laparoscopic vs open surgery for resection of rectal cancer, using unselected data from the public healthcare system of Catalonia (Spain). Methods This was a multicentre retrospective cohort study of all patients who had surgery with curative intent for primary rectal cancer at Catalonian public hospitals from 2011 to 2012. We obtained follow‐up data for up to 5 years. To minimize the differences between the two groups, we performed propensity score matching on baseline patient characteristics. We used multivariate Cox proportional hazards regression analyses to assess locoregional relapse at 2 years and death at 2 and 5 years. Results Of 1513 patients with Stage I-III rectal cancer, 933 (61.7%) had laparoscopy (conversion rate 13.2%). After applying our propensity score matching strategy (2:1), 842 laparoscopy patients were matched to 517 open surgery patients. Multivariate Cox analysis of death at 2 years [hazard ratio (HR) 0.65, 95% CI 0.48, 0.87; P = 0.004] and 5 years (HR 0.61, 95% CI 0.5, 0.75; P < 0.001) and of local relapse at 2 years (HR 0.44, 95% CI 0.27, 0.72; P = 0.001) showed laparoscopy to be an independent protective factor compared with open surgery. Conclusions Laparoscopy results in lower locoregional relapse and long‐term mortality in rectal cancer in unselected patients with all‐risk groups included. Studies using long‐term follow‐up of cohorts and unselected data can provide information on clinically relevant outcomes to supplement randomized controlled trials.

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