Hong Kong Med J 2011;17:26–32 | Number 1, February 2011
Clinical outcome of open and laparoscopic surgery in Dukes' B and C rectal cancer: experience from a regional hospital in Hong Kong
Weida Day, Patrick YY Lau, KM Li, SY Kwok, Andrew WC Yip
Department of Surgery, Kwong Wah Hospital, 25 Waterloo Road, Hong Kong
OBJECTIVE. To compare the long-term outcome of open and laparoscopic surgery for Dukes' B and C rectal cancer in a regional hospital in Hong Kong.
DESIGN. Retrospective study.
SETTING. A regional hospital in Hong Kong.
MAIN OUTCOME MEASURES. Survival and local recurrence rates.
PATIENTS. Patients with Dukes' B and C rectal cancers underwent elective curative open or laparoscopic surgery during the period December 2000 to December 2006.
RESULTS. A total of 222 patients (open surgery, n=133; laparoscopic surgery, n=89) were assessed. The overall 3- and 5-year survival rates for all patients were 72% and 58%, respectively. Local recurrence rates were similar in both groups. Laparoscopic group had better overall survival (P=0.014), however. The overall 3-year survival rates were 79% and 68% in the laparoscopic and open groups, respectively. The corresponding 5-year rates were 75% and 52%. Multivariate analysis also demonstrated that laparoscopic surgery was a significant independent factor for better survival. Chemotherapy, local recurrence, lymph node metastasis, and poorly differentiated tumour were significantly associated with survival.
CONCLUSION. Laparoscopic surgery for Dukes' B and C rectal cancer was associated with more favourable survival than with open surgery.
Key words: Disease-free survival; Laparoscopy; Neoplasm recurrence, local; Rectal neoplasms; Treatment outcome
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