Randomized Controlled Trial

. 2017 Jun;31(6):2607-2615.

doi: 10.1007/s00464-016-5270-6. Epub 2016 Oct 12.

Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer

Collaborators, Affiliations

Collaborators

COLOR (COlon cancer Laparoscopic or Open Resection) study group:
R Hellberg, E Haglind, G Kurlberg, P G Lindgren, E Lindholm, L Påhlman, M Dahlberg, Y Raab, B Anderberg, S Ewerth, M Janson, J E Åkerlund, K Smedh, A Montgomery, S Skullman, P O Nyström, A Kald, A Wänström, J Dàlen, I Svedberg, G Edlund, U Kressner, A N Öberg, O Lundberg, G E Lindmark, T Heikkinen, M Morino, G Giraudo, A M Lacy, S Delgado, E Macarulla Sanz, J Medina Díez, O Schwandner, T H Schiedeck, H Shekarriz, C Bloechle, I Baca, O Weiss, S Msika, G Desvignes, K L Campbell, A Cuschieri, H J Bonjer, W R Schouten, G Kazemier, J F Lange, E van der Harst, P P L O Coene, P Plaisier, M J O E Bertleff, M A Cuesta, W van der Broek, W J H J Meijerink, J J Jakimowicz, G Nieuwenhuijzen, J Maring, J Kivit, I M C Janssen, E J Spillenaar-Bilgen, F Berends

Affiliations

¹ Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
² Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
³ Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
⁴ Department of Design Engineering, Delft University of Technology, Delft, The Netherlands.
⁵ Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
⁶ Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
⁷ Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
⁸ Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. j.bonjer@vumc.nl.

PMID: 27734203
PMCID: PMC5443846
DOI: 10.1007/s00464-016-5270-6

Randomized Controlled Trial

Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer

Charlotte L Deijen et al. Surg Endosc. 2017 Jun.

. 2017 Jun;31(6):2607-2615.

doi: 10.1007/s00464-016-5270-6. Epub 2016 Oct 12.

Authors

Collaborators

COLOR (COlon cancer Laparoscopic or Open Resection) study group:
R Hellberg, E Haglind, G Kurlberg, P G Lindgren, E Lindholm, L Påhlman, M Dahlberg, Y Raab, B Anderberg, S Ewerth, M Janson, J E Åkerlund, K Smedh, A Montgomery, S Skullman, P O Nyström, A Kald, A Wänström, J Dàlen, I Svedberg, G Edlund, U Kressner, A N Öberg, O Lundberg, G E Lindmark, T Heikkinen, M Morino, G Giraudo, A M Lacy, S Delgado, E Macarulla Sanz, J Medina Díez, O Schwandner, T H Schiedeck, H Shekarriz, C Bloechle, I Baca, O Weiss, S Msika, G Desvignes, K L Campbell, A Cuschieri, H J Bonjer, W R Schouten, G Kazemier, J F Lange, E van der Harst, P P L O Coene, P Plaisier, M J O E Bertleff, M A Cuesta, W van der Broek, W J H J Meijerink, J J Jakimowicz, G Nieuwenhuijzen, J Maring, J Kivit, I M C Janssen, E J Spillenaar-Bilgen, F Berends

Affiliations

¹ Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
² Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
³ Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
⁴ Department of Design Engineering, Delft University of Technology, Delft, The Netherlands.
⁵ Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
⁶ Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
⁷ Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
⁸ Department of Surgery, VU University Medical Centre, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands. j.bonjer@vumc.nl.

PMID: 27734203
PMCID: PMC5443846
DOI: 10.1007/s00464-016-5270-6

Abstract

Background: Laparoscopic surgery for colon cancer is associated with improved recovery and similar cancer outcomes at 3 and 5 years in comparison with open surgery. However, long-term survival rates have rarely been reported. Here, we present survival and recurrence rates of the Dutch patients included in the COlon cancer Laparoscopic or Open Resection (COLOR) trial at 10-year follow-up.

Methods: Between March 1997 and March 2003, patients with non-metastatic colon cancer were recruited by 29 hospitals in eight countries and randomised to either laparoscopic or open surgery. Main inclusion criterion for the COLOR trial was solitary adenocarcinoma of the left or right colon. The primary outcome was disease-free survival at 3 years, and secondary outcomes included overall survival and recurrence. The 10-year follow-up data of all Dutch patients were collected. Analysis was by intention-to-treat. The trial was registered at ClinicalTrials.gov (NCT00387842).

Results: In total, 1248 patients were randomised, of which 329 were Dutch. Fifty-eight Dutch patients were excluded and 15 were lost to follow-up, leaving 256 patients for 10-year analysis. Median follow-up was 112 months. Disease-free survival rates were 45.2 % in the laparoscopic group and 43.2 % in the open group (difference 2.0 %; 95 % confidence interval (CI) -10.3 to 14.3; p = 0.96). Overall survival rates were 48.4 and 46.7 %, respectively (difference 1.7 %; 95 % CI -10.6 to 14.0; p = 0.83). Stage-specific analysis revealed similar survival rates for both groups. Sixty-two patients were diagnosed with recurrent disease, accounting for 29.4 % in the laparoscopic group and 28.2 % in the open group (difference 1.2 %; 95 % CI -11.1 to 13.5; p = 0.73). Seven patients had port- or wound-site recurrences (laparoscopic n = 3 vs. open n = 4).

Conclusions: Laparoscopic surgery for non-metastatic colon cancer is associated with similar rates of disease-free survival, overall survival and recurrences as open surgery at 10-year follow-up.

Keywords: Colon cancer; Laparoscopic; Randomised clinical trial; Surgery; Treatment.

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Conflict of interest statement

Dr. Haglind reports grants from Swedish Cancer Foundation, during the conduct of the study; grants from Sahlgrenska University Hospital, Swedish Research Council (2012-1770), grants from Swedish Research Council, grants from Mary von Sydow Foundation, grants from Anna and Anna and Edvin Berger Foundation, grants from Region Västra, Västra Götaland Region, outside the submitted work. Dr. Bonjer reports grants from Ethicon EndoSurgery Europe, during the conduct of the study; grants and personal fees from JOHNSON & JOHNSON, grants and personal fees from APPLIED MEDICAL, grants and personal fees from MEDTRONIC, grants and personal fees from OLYMPUS, personal fees from COOK, outside the submitted work. Sponsors had no role in the study design, data collection, data analysis, data interpretation or writing the report. The corresponding author had full access to all the data in study and had final responsibility for the decision to submit for publication. Drs. Deijen, Vasmel, de Lange-de Klerk, Cuesta, Coene, Lange, Meijerink, Jakimowicz, Jeekel, Kazemier and Janssen have no conflicts of interest or financial ties to disclose.

Figures

**Fig. 2**
Disease-free survival. A All stages, B stage I, C stage II and D stage III

**Fig. 3**
Recurrence. A All stages, B stage I, C stage II and D stage III

See this image and copyright information in PMC

References

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Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer

Collaborators

Affiliations

Ten-year outcomes of a randomised trial of laparoscopic versus open surgery for colon cancer

Authors

Collaborators

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Associated data

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical