COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY
Autor(a) principal: | |
---|---|
Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.34635/rpc.944 |
Resumo: | Introduction: This study aimed to compare the 3-year rates of local recurrence (LR) and overall survival (OS) for open (OPEN) and laparoscopic (LAP) surgeries in a Portuguese registry. Material and Methods: This observational study included patients who underwent rectal cancer resection performed in 16 hospitals between July 2014 and December 2019. The radiologic staging and the specimen images of the first three cases of any hospital were uploaded and audited by the scientific committee. Clinical and pathological characteristics and short and long-term outcomes of OPEN and LAP surgeries were analyzed. Results: The registry included 640 patients who underwent rectal cancer surgery: 562 (87.8%) underwent curative resection and 78 (12.2%) underwent palliative resection. In the curative cohort, OPEN surgery was performed in 269 cases whereas LAP surgery, which had a conversion rate of 17.5%, was performed in 266 cases. The pN staging showed that the LAP group had less advanced disease than the OPEN group. Anterior resection was performed in 57.8% of the cases whereas abdominoperineal resection was performed in 16.5%. Patients who underwent LAP surgery had shorter hospital stays. The 3-year LR rate was 3.0% (95% CI, 1.4%-6.3%) for LAP surgery and 8.3% (95% CI, 5.1%-13.1%) for OPEN surgery (P=0.02). The 3-year OS was 88.2% (95% CI, 83.1%-92.0%) for LAP surgery and 76.5% (95% CI, 69.1%-82.6%) for OPEN surgery (P=0.0061). Discussion: LAP surgery for patients with rectal cancer is associated with a decreased LR rate and improved OS, although in those with less advanced pN staging. Conclusion: The data support the view that the LAP approach is justified for rectal cancer when performed by surgeons with appropriate laparoscopic experience. |
id |
RCAP_ed15f6ac5e280abb90ec1eac8348613d |
---|---|
oai_identifier_str |
oai:revista.spcir.com:article/944 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRYCOMPARAÇÃO DA CIRURGIA CONVENCIONAL COM A LAPAROSCÓPICA NO CANCRO DO RETO: RESULTADOS DO REGISTO PORTUGUÊSIntroduction: This study aimed to compare the 3-year rates of local recurrence (LR) and overall survival (OS) for open (OPEN) and laparoscopic (LAP) surgeries in a Portuguese registry. Material and Methods: This observational study included patients who underwent rectal cancer resection performed in 16 hospitals between July 2014 and December 2019. The radiologic staging and the specimen images of the first three cases of any hospital were uploaded and audited by the scientific committee. Clinical and pathological characteristics and short and long-term outcomes of OPEN and LAP surgeries were analyzed. Results: The registry included 640 patients who underwent rectal cancer surgery: 562 (87.8%) underwent curative resection and 78 (12.2%) underwent palliative resection. In the curative cohort, OPEN surgery was performed in 269 cases whereas LAP surgery, which had a conversion rate of 17.5%, was performed in 266 cases. The pN staging showed that the LAP group had less advanced disease than the OPEN group. Anterior resection was performed in 57.8% of the cases whereas abdominoperineal resection was performed in 16.5%. Patients who underwent LAP surgery had shorter hospital stays. The 3-year LR rate was 3.0% (95% CI, 1.4%-6.3%) for LAP surgery and 8.3% (95% CI, 5.1%-13.1%) for OPEN surgery (P=0.02). The 3-year OS was 88.2% (95% CI, 83.1%-92.0%) for LAP surgery and 76.5% (95% CI, 69.1%-82.6%) for OPEN surgery (P=0.0061). Discussion: LAP surgery for patients with rectal cancer is associated with a decreased LR rate and improved OS, although in those with less advanced pN staging. Conclusion: The data support the view that the LAP approach is justified for rectal cancer when performed by surgeons with appropriate laparoscopic experience.Introdução: O objetivo do estudo consistiu na avaliação da recidiva local (RL) e da sobrevivência global (SG) aos 3 anos, comparando cirurgia convencional (CONV) e laparoscópica (LAP) no registo Português do cancro do reto. Material e Métodos: Neste estudo observacional incluíram-se doentes com cirurgia por cancro do reto realizada em 16 hospitais, entre Julho 2014 e Dezembro 2019. O estadiamento imagiológico e as imagens anatomopatológicas foram registadas e auditadas pela comissão científica. Analisaram-se as características clinico-patológicas e os resultados pós-operatórios e à distância na cirurgia CONV e LAP. Resultados: O registo inclui 640 doentes que realizaram cirurgia por cancro do reto: 562 (87.8%) resseções curativas e 78 (12.2%) resseções paliativas. No grupo curativo foram realizadas 269 resseções CONV e 266 resseções LAP, que tiveram conversão em 17,5% dos casos. O grupo LAP tinha estadiamento pN menos avançado que o grupo CONV. A resseção anterior foi realizada em 57,8% dos casos e a amputação abdominoperineal em 16,5%. Os doentes com cirurgia LAP tiveram estadia pós-operatória mais curta. A taxa de RL aos 3 anos foi de 3,0% (95% CI, 1,4%-6,3%) na cirurgia LAP e 8,3% (95% CI, 5.1%-13,1%) na cirurgia CONV (P=0.02). A SG aos 3 anos foi 88,2% (95% CI, 83,1%-92,0%) na cirurgia LAP e 76,5% (95% CI, 69,1%-82,6%) na cirurgia CONV (P=0.0061). Discussão: Nos doentes com cancro do reto a cirurgia LAP associou-se a menor taxa de RL e melhor SG, embora em doentes com estadiamento pN menos avançado. Conclusão: Estes resultados confirmam que no cancro do reto a abordagem LAP é segura se for realizada por cirurgiões com adequada experiência laparoscópica.Sociedade Portuguesa de Cirurgia2023-03-21info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.944https://doi.org/10.34635/rpc.944Revista Portuguesa de Cirurgia; No 54 (2022): December; 35-48Revista Portuguesa de Cirurgia; No 54 (2022): December; 35-482183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttps://revista.spcir.com/index.php/spcir/article/view/944https://revista.spcir.com/index.php/spcir/article/view/944/669Copyright (c) 2023 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessLeite, J. S.Pimentel, J.Silva, P. C.Gíria, J.Alves, F. C.Semedo, L.Venâncio, J.Guimarães, L.Rui, M.Brito, M. J.Fonseca, R.Lopes, J.Oliveiros, B.2024-03-14T22:05:13Zoai:revista.spcir.com:article/944Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:51.303480Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY COMPARAÇÃO DA CIRURGIA CONVENCIONAL COM A LAPAROSCÓPICA NO CANCRO DO RETO: RESULTADOS DO REGISTO PORTUGUÊS |
title |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY |
spellingShingle |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY Leite, J. S. |
title_short |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY |
title_full |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY |
title_fullStr |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY |
title_full_unstemmed |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY |
title_sort |
COMPARISON OF THE OUTCOMES OF OPEN AND LAPAROSCOPIC RECTAL CANCER SURGERIES: RESULTS FROM A PORTUGUESE REGISTRY |
author |
Leite, J. S. |
author_facet |
Leite, J. S. Pimentel, J. Silva, P. C. Gíria, J. Alves, F. C. Semedo, L. Venâncio, J. Guimarães, L. Rui, M. Brito, M. J. Fonseca, R. Lopes, J. Oliveiros, B. |
author_role |
author |
author2 |
Pimentel, J. Silva, P. C. Gíria, J. Alves, F. C. Semedo, L. Venâncio, J. Guimarães, L. Rui, M. Brito, M. J. Fonseca, R. Lopes, J. Oliveiros, B. |
author2_role |
author author author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Leite, J. S. Pimentel, J. Silva, P. C. Gíria, J. Alves, F. C. Semedo, L. Venâncio, J. Guimarães, L. Rui, M. Brito, M. J. Fonseca, R. Lopes, J. Oliveiros, B. |
description |
Introduction: This study aimed to compare the 3-year rates of local recurrence (LR) and overall survival (OS) for open (OPEN) and laparoscopic (LAP) surgeries in a Portuguese registry. Material and Methods: This observational study included patients who underwent rectal cancer resection performed in 16 hospitals between July 2014 and December 2019. The radiologic staging and the specimen images of the first three cases of any hospital were uploaded and audited by the scientific committee. Clinical and pathological characteristics and short and long-term outcomes of OPEN and LAP surgeries were analyzed. Results: The registry included 640 patients who underwent rectal cancer surgery: 562 (87.8%) underwent curative resection and 78 (12.2%) underwent palliative resection. In the curative cohort, OPEN surgery was performed in 269 cases whereas LAP surgery, which had a conversion rate of 17.5%, was performed in 266 cases. The pN staging showed that the LAP group had less advanced disease than the OPEN group. Anterior resection was performed in 57.8% of the cases whereas abdominoperineal resection was performed in 16.5%. Patients who underwent LAP surgery had shorter hospital stays. The 3-year LR rate was 3.0% (95% CI, 1.4%-6.3%) for LAP surgery and 8.3% (95% CI, 5.1%-13.1%) for OPEN surgery (P=0.02). The 3-year OS was 88.2% (95% CI, 83.1%-92.0%) for LAP surgery and 76.5% (95% CI, 69.1%-82.6%) for OPEN surgery (P=0.0061). Discussion: LAP surgery for patients with rectal cancer is associated with a decreased LR rate and improved OS, although in those with less advanced pN staging. Conclusion: The data support the view that the LAP approach is justified for rectal cancer when performed by surgeons with appropriate laparoscopic experience. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-03-21 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.34635/rpc.944 https://doi.org/10.34635/rpc.944 |
url |
https://doi.org/10.34635/rpc.944 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://revista.spcir.com/index.php/spcir/article/view/944 https://revista.spcir.com/index.php/spcir/article/view/944/669 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2023 Revista Portuguesa de Cirurgia info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2023 Revista Portuguesa de Cirurgia |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Cirurgia |
dc.source.none.fl_str_mv |
Revista Portuguesa de Cirurgia; No 54 (2022): December; 35-48 Revista Portuguesa de Cirurgia; No 54 (2022): December; 35-48 2183-1165 1646-6918 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799138182859587584 |