Laparoscopic colectomy for cancer: Improved compliance with guidelines for chemotherapy and survival
Background Laparoscopic surgery for colon cancer has been demonstrated in clinical trials to have short-term benefits when compared to the open surgical approach. Guidelines of the National Comprehensive Cancer Network recommend that patients with stage III or high-risk stage II colon cancer undergo...
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| Veröffentlicht in: | Surgery 2017-06, Vol.161 (6), p.1633-1641 |
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| creator | Kim, Roger H., MD Kavanaugh, Mindie M., MD Caldito, Gloria C., PhD |
| description | Background Laparoscopic surgery for colon cancer has been demonstrated in clinical trials to have short-term benefits when compared to the open surgical approach. Guidelines of the National Comprehensive Cancer Network recommend that patients with stage III or high-risk stage II colon cancer undergo adjuvant chemotherapy. We hypothesized that laparoscopic colectomy is associated with increased compliance to recommendations for chemotherapy, a lesser time to start of chemotherapy, and increased overall survival. Methods The National Cancer Data Base was queried to identify patients with stage III or high-risk stage II colon cancer (T4, positive margins, |
| doi_str_mv | 10.1016/j.surg.2016.11.024 |
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Guidelines of the National Comprehensive Cancer Network recommend that patients with stage III or high-risk stage II colon cancer undergo adjuvant chemotherapy. We hypothesized that laparoscopic colectomy is associated with increased compliance to recommendations for chemotherapy, a lesser time to start of chemotherapy, and increased overall survival. Methods The National Cancer Data Base was queried to identify patients with stage III or high-risk stage II colon cancer (T4, positive margins, <12 lymph nodes, or high tumor grade) diagnosed 2010–2012. Patients were divided into laparoscopic colectomy and open colectomy groups. Intent-to-treat analysis was used with converted cases included in the laparoscopic colectomy group. Rates of receiving adjuvant chemotherapy, time from diagnosis and date of operation to start of chemotherapy, and overall survival were compared. Results A total of 48,257 patients were included for analysis; 18,801 patients underwent laparoscopic colectomy and 29,456 underwent open colectomy. Laparoscopic colectomy patients received adjuvant chemotherapy at a somewhat greater rate than open colectomy (66.2% vs 59.4%, P < .01). Among patients who received chemotherapy, mean time to start of chemotherapy after definitive resection was somewhat less for laparoscopic colectomy than open colectomy (48.7 vs 52.7 days, P < .01). Two-year overall survival was greater for laparoscopic colectomy than open colectomy (81.9% vs 73.2%, P < .01). Conclusion Compared to open colectomy, laparoscopic colectomy is associated with somewhat greater rates of compliance with guidelines for adjuvant chemotherapy for stage III and high-risk stage II colon cancer, as well as a slightly lesser time to start of chemotherapy and improved overall survival.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2016.11.024</identifier><identifier>PMID: 28027818</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma - drug therapy ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Chemotherapy, Adjuvant ; Colectomy - methods ; Colectomy - mortality ; Colonic Neoplasms - drug therapy ; Colonic Neoplasms - mortality ; Colonic Neoplasms - pathology ; Colonic Neoplasms - surgery ; Databases, Factual ; Disease-Free Survival ; Female ; Guideline Adherence - statistics & numerical data ; Humans ; Laparoscopy - methods ; Laparoscopy - mortality ; Laparotomy - methods ; Laparotomy - mortality ; Logistic Models ; Male ; Middle Aged ; Neoplasm Invasiveness - pathology ; Neoplasm Staging ; Practice Guidelines as Topic ; Prognosis ; Retrospective Studies ; Risk Assessment ; Surgery ; Survival Rate</subject><ispartof>Surgery, 2017-06, Vol.161 (6), p.1633-1641</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-72b0c376b6a417fb2c7818edf1ddb0b9d326edf3b925b481749b00123c7be9783</citedby><cites>FETCH-LOGICAL-c411t-72b0c376b6a417fb2c7818edf1ddb0b9d326edf3b925b481749b00123c7be9783</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.surg.2016.11.024$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28027818$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Roger H., MD</creatorcontrib><creatorcontrib>Kavanaugh, Mindie M., MD</creatorcontrib><creatorcontrib>Caldito, Gloria C., PhD</creatorcontrib><title>Laparoscopic colectomy for cancer: Improved compliance with guidelines for chemotherapy and survival</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Background Laparoscopic surgery for colon cancer has been demonstrated in clinical trials to have short-term benefits when compared to the open surgical approach. Guidelines of the National Comprehensive Cancer Network recommend that patients with stage III or high-risk stage II colon cancer undergo adjuvant chemotherapy. We hypothesized that laparoscopic colectomy is associated with increased compliance to recommendations for chemotherapy, a lesser time to start of chemotherapy, and increased overall survival. Methods The National Cancer Data Base was queried to identify patients with stage III or high-risk stage II colon cancer (T4, positive margins, <12 lymph nodes, or high tumor grade) diagnosed 2010–2012. Patients were divided into laparoscopic colectomy and open colectomy groups. Intent-to-treat analysis was used with converted cases included in the laparoscopic colectomy group. Rates of receiving adjuvant chemotherapy, time from diagnosis and date of operation to start of chemotherapy, and overall survival were compared. Results A total of 48,257 patients were included for analysis; 18,801 patients underwent laparoscopic colectomy and 29,456 underwent open colectomy. Laparoscopic colectomy patients received adjuvant chemotherapy at a somewhat greater rate than open colectomy (66.2% vs 59.4%, P < .01). Among patients who received chemotherapy, mean time to start of chemotherapy after definitive resection was somewhat less for laparoscopic colectomy than open colectomy (48.7 vs 52.7 days, P < .01). Two-year overall survival was greater for laparoscopic colectomy than open colectomy (81.9% vs 73.2%, P < .01). Conclusion Compared to open colectomy, laparoscopic colectomy is associated with somewhat greater rates of compliance with guidelines for adjuvant chemotherapy for stage III and high-risk stage II colon cancer, as well as a slightly lesser time to start of chemotherapy and improved overall survival.</description><subject>Adenocarcinoma - drug therapy</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chemotherapy, Adjuvant</subject><subject>Colectomy - methods</subject><subject>Colectomy - mortality</subject><subject>Colonic Neoplasms - drug therapy</subject><subject>Colonic Neoplasms - mortality</subject><subject>Colonic Neoplasms - pathology</subject><subject>Colonic Neoplasms - surgery</subject><subject>Databases, Factual</subject><subject>Disease-Free Survival</subject><subject>Female</subject><subject>Guideline Adherence - statistics & numerical data</subject><subject>Humans</subject><subject>Laparoscopy - methods</subject><subject>Laparoscopy - mortality</subject><subject>Laparotomy - methods</subject><subject>Laparotomy - mortality</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Staging</subject><subject>Practice Guidelines as Topic</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Surgery</subject><subject>Survival Rate</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2P0zAQhi0EYsvCH-CAcuSSMGOncYIQ0mrFx0qVOABnyx-TrUtSBzsp6r_HURcOHDjZHr_z6p1nGHuJUCFg8-ZQpSXeVzzfK8QKeP2IbXAreClFg4_ZBkB0ZQMNXLFnKR0AoKuxfcqueAtctthumNvpSceQbJi8LWwYyM5hPBd9iIXVR0vxbXE3TjGcyOXvcRr8Wi1--Xlf3C_e0eCPlC76PY1h3lPU07nQR1fkeCd_0sNz9qTXQ6IXD-c1-_7xw7fbz-Xuy6e725tdaWvEuZTcgBWyMY2uUfaG2zUjuR6dM2A6J3iTX8J0fGvqFmXdGQDkwkpDnWzFNXt98c15fy6UZjX6ZGkY9JHCkhS2WyHrrWjrLOUXqc3Dp0i9mqIfdTwrBLXSVQe10lUrXYWoMt3c9OrBfzEjub8tf3BmwbuLgPKUJ09RJesp83I-ZrDKBf9___f_tNtM11s9_KAzpUNY4jHzU6gSV6C-rvtd14uNANkJEL8BBIeh6g</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Kim, Roger H., MD</creator><creator>Kavanaugh, Mindie M., MD</creator><creator>Caldito, Gloria C., PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170601</creationdate><title>Laparoscopic colectomy for cancer: Improved compliance with guidelines for chemotherapy and survival</title><author>Kim, Roger H., MD ; Kavanaugh, Mindie M., MD ; Caldito, Gloria C., PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-72b0c376b6a417fb2c7818edf1ddb0b9d326edf3b925b481749b00123c7be9783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adenocarcinoma - drug therapy</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chemotherapy, Adjuvant</topic><topic>Colectomy - methods</topic><topic>Colectomy - mortality</topic><topic>Colonic Neoplasms - drug therapy</topic><topic>Colonic Neoplasms - mortality</topic><topic>Colonic Neoplasms - pathology</topic><topic>Colonic Neoplasms - surgery</topic><topic>Databases, Factual</topic><topic>Disease-Free Survival</topic><topic>Female</topic><topic>Guideline Adherence - statistics & numerical data</topic><topic>Humans</topic><topic>Laparoscopy - methods</topic><topic>Laparoscopy - mortality</topic><topic>Laparotomy - methods</topic><topic>Laparotomy - mortality</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Staging</topic><topic>Practice Guidelines as Topic</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Surgery</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Roger H., MD</creatorcontrib><creatorcontrib>Kavanaugh, Mindie M., MD</creatorcontrib><creatorcontrib>Caldito, Gloria C., PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Roger H., MD</au><au>Kavanaugh, Mindie M., MD</au><au>Caldito, Gloria C., PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic colectomy for cancer: Improved compliance with guidelines for chemotherapy and survival</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>161</volume><issue>6</issue><spage>1633</spage><epage>1641</epage><pages>1633-1641</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract>Background Laparoscopic surgery for colon cancer has been demonstrated in clinical trials to have short-term benefits when compared to the open surgical approach. Guidelines of the National Comprehensive Cancer Network recommend that patients with stage III or high-risk stage II colon cancer undergo adjuvant chemotherapy. We hypothesized that laparoscopic colectomy is associated with increased compliance to recommendations for chemotherapy, a lesser time to start of chemotherapy, and increased overall survival. Methods The National Cancer Data Base was queried to identify patients with stage III or high-risk stage II colon cancer (T4, positive margins, <12 lymph nodes, or high tumor grade) diagnosed 2010–2012. Patients were divided into laparoscopic colectomy and open colectomy groups. Intent-to-treat analysis was used with converted cases included in the laparoscopic colectomy group. Rates of receiving adjuvant chemotherapy, time from diagnosis and date of operation to start of chemotherapy, and overall survival were compared. Results A total of 48,257 patients were included for analysis; 18,801 patients underwent laparoscopic colectomy and 29,456 underwent open colectomy. Laparoscopic colectomy patients received adjuvant chemotherapy at a somewhat greater rate than open colectomy (66.2% vs 59.4%, P < .01). Among patients who received chemotherapy, mean time to start of chemotherapy after definitive resection was somewhat less for laparoscopic colectomy than open colectomy (48.7 vs 52.7 days, P < .01). Two-year overall survival was greater for laparoscopic colectomy than open colectomy (81.9% vs 73.2%, P < .01). Conclusion Compared to open colectomy, laparoscopic colectomy is associated with somewhat greater rates of compliance with guidelines for adjuvant chemotherapy for stage III and high-risk stage II colon cancer, as well as a slightly lesser time to start of chemotherapy and improved overall survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28027818</pmid><doi>10.1016/j.surg.2016.11.024</doi><tpages>9</tpages></addata></record> |
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| subjects | Adenocarcinoma - drug therapy Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over Chemotherapy, Adjuvant Colectomy - methods Colectomy - mortality Colonic Neoplasms - drug therapy Colonic Neoplasms - mortality Colonic Neoplasms - pathology Colonic Neoplasms - surgery Databases, Factual Disease-Free Survival Female Guideline Adherence - statistics & numerical data Humans Laparoscopy - methods Laparoscopy - mortality Laparotomy - methods Laparotomy - mortality Logistic Models Male Middle Aged Neoplasm Invasiveness - pathology Neoplasm Staging Practice Guidelines as Topic Prognosis Retrospective Studies Risk Assessment Surgery Survival Rate |
| title | Laparoscopic colectomy for cancer: Improved compliance with guidelines for chemotherapy and survival |
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