Current best practices and rationalistic perspectives in causation-based prevention, early detection and multidisciplinary treatment of breast and gastric cancer

Gastric & Breast Cancer e-journal
DOI: 10.2122/gbc.2009.0110


Laparoscopic Colectomy: No Evidence for Survival Benefit in Colon Cancer

Dimosthenis Ziogas, MD

Affiliation: Dimosthenis Ziogas M.D., Surgical Oncology Research Unit, Dept of Surgery, University of Ioannina, School of Medicine, 45110 Ioannina, Greece.
Since there is no abstract available we provide the first paragraph    
Can the laparoscopic approach improve survival of patients with colon cancer? This is a crucial question for thousands of patients and many physicians in the industrialized world. It is well-known that the laparoscopic approach improves the quality of life in the early postoperative period. But, its impact on long-term clinical outcomes is controversial. Lacy et al [1] in the July 2008 issue of the Annals of Surgery report on a randomized trial and conclude that laparoscopy-assisted colectomy (LAC) as compared with open colectomy (OC) for nonmetastatic colon cancer significantly improves recurrence-free and overall survival. Given the major clinical implications of this finding, if it is true, we would like to comment on whether this is a robust conclusion or, due to potential biases, this finding can be interpreted as a chance occurrence. To explain the unexpected survival superiority of LAC, particularly in advanced tumor stage, Lacy et al have dedicated all the discussion of this study [1] to support the hypothesis of differences in surgical stress response, cellular immunity, tumor handling, and complication rate between the 2 groups, of closed and open colectomy. However, evidence of each or all of these hypotheses is inadequate. Additionally, the authors are unable to exclude selection biases and to explain the contradictory results of all other randomized trials available.
You can have an online full-text access and a PDF of this article:
  • Either purchase this paper for €33 EUR. Please, click here
Please specify DOI of article
  • Or through one year subscription PayPal

Online ISSN : 1109 - 7647
   Print ISSN : 1109 - 7655

We subscribe to the HONcode principles of the HON Foundation. Click to verify. We subscribe to the HONcode principles. Verify here.
please, read our policy about privacy and confidentiality of information and transparency of sponsorship

last update: 3 February 2004