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Long-Term Outcomes of the Australasian Randomized Clinical Trial Comparing Laparoscopic and Conventional Open Surgical Treatments for Colon Cancer: The Australasian Laparoscopic Colon Cancer Study Trial.
MedLine Citation:
PMID:  23154392     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:: We report a multicentered randomized controlled trial across Australia and New Zealand comparing laparoscopic-assisted colon resection (LCR) with open colon resection (OCR) for colon cancer. BACKGROUND:: Colon cancer is a significant worldwide health issue. This trial investigated whether the short-term benefits associated with LCR for colon cancer could be achieved safely, without survival disadvantages, in our region. METHODS:: A total of 601 patients with potentially curable colon cancer were randomized to receive LCR or OCR. Primary endpoints were 5-year overall survival, recurrence-free survival, and freedom from recurrence rates, compared using an intention-to-treat analysis. RESULTS:: On April 5, 2010, 587 eligible patients were followed for a median of 5.2 years (range, 1 week-11.4 years) with 5-year confirmed follow-up data for survival and recurrence on 567 (96.6%). Significant differences between the 2 trial groups were as follows: LCR patients were older at randomization, and their pathology specimens showed smaller distal resection margins; OCR patients had some worse pathology parameters, but there were no differences in disease stages. There were no significant differences between the LCR and OCR groups in 5-year follow-up of overall survival (77.7% vs 76.0%, P = 0.64), recurrence-free survival (72.7% vs 71.2%, P = 0.70), or freedom from recurrence (86.2% vs 85.6%, P = 0.85). CONCLUSIONS:: In spite of some differences in short-term surrogate oncological markers, LCR was not inferior to OCR in direct measures of survival and disease recurrence. These findings emphasize the importance of long-term data in formulating evidence-based practice guidelines.
Authors:
Philip F Bagshaw; Randall A Allardyce; Christopher M Frampton; Francis A Frizelle; Peter J Hewett; Paul J McMurrick; Nicholas A Rieger; J Shona Smith; Michael J Solomon; Andrew Rl Stevenson;
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Annals of surgery     Volume:  256     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  915-919     Citation Subset:  -    
Affiliation:
*Departments of Surgery †Medicine University of Otago ‡Academy of Endosurgery, Christchurch, New Zealand §¶Division of Surgery, The Queen Elizabeth Hospital, Woodville and the University of Adelaide, South Australia ‖Department of Surgery, Monash University and Cabrini Hospital, Malvern, Victoria #Department of Colon & Rectal Surgery, Royal Prince Alfred Hospital and Surgical Outcomes Research Centre (SOuRCe), University of Sydney **Department of Colon and Rectal Surgery, Royal Brisbane & Women's Hospital, Herston, Australia ††Participating members of the Australasian Laparoscopic Colon Cancer Study Group are listed under Acknowledgements.
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