A Meta-analysis Of The Long-term Outcomes Of Laparoscopic And Open Surgery For Colon Cancer

Objective: To compare the long-term outcomes of laparoscopic surgery (LS) and open surgery (OS) for colon cancer.Methods: The randomized controlled trials between January 1995 and December 2009,reported on the long-term outcomes of laparoscopic versus open surgery for colon cancer, were collected by searches of PUBMED, Ovid, CHKD and the"WEI PU"database.Data were extracted from these trials and data analysis was performed by RevMan4.2.8.Results: According to the same screening criteria, a total of 2480 patients from 6 trials were included (1240 patients in the LS group and 1240 patients in the OS group). Age, gender, tumor stage and ASA class were similar in the two groups. There was no statistical difference in the long-term outcomes between the two groups. The overall recurrence were 18.3% (223/1220) in the LS group versus 19.5% (235/1207) in the OS group, and OR: 0.92, 95%CI (0.75, 1.13), P=0.43. The local recurrence were 8.5% (57/670) in the LS group versus 7.7% (52/678) in the OS group, and OR: 1.11, 95%CI (0.75, 1.64), P=0.60. The distant metastasis were 13.5% (109/805) in the LS group versus 13.1% (106/812) in the OS group, and OR: 1.04, 95%CI (0.78, 1.39), P=0.78. The port-site or wound-site metastasis were 1.1% (14/1220) in the LS group versus 0.7% (9/1207) in the OS group, and OR: 1.54, 95%CI (0.66, 3.59), P=0.32. The 3-year overall survival were 69.4% (732/1055) in the LS group versus 71.1% (739/1039) in the OS group, and OR: 0.93, 95%CI (0.77, 1.12), P=0.43. The 5-year overall survival were 32.6% (344/1055) in the LS group versus 32.9% (342/1039) in the OS group, and OR: 0.99, 95%CI (0.82, 1.19), P=0.90. The 3-year disease-free survival were 62.8% (681/1084) in the LS group versus 64.4% (690/1071) in the OS group, and OR: 0.94, 95%CI (0.79, 1.12), P=0.47. The 5-year disease-free survival were 27.5% (298/1084) in the LS group versus 27.6% (296/1071) in the OS group, and OR: 0.99, 95%CI (0.82, 1.20), P=0.95.Conclusions: The long-term outcomes were very similar between laparoscopic and open surgery for colon cancer. Laparoscopic surgery for colon cancer is an acceptable alternative.