Laparoscopic resection does not adversely affect early survival curves in patients undergoing surgery for colorectal adenocarcinoma

Objective To determine the survival curves for laparoscopic resection (LR) of colorectal cancer. Summary Background Data Laparoscopic resection for cure of colorectal cance r is controversial, and survival curves have not been determined. Methods A prospective database of 177 consecutive LRs of colorectal cancers performed between November 1991 and 1997 was reviewed. The TNM classificat ion (stage 0, I, II, III, and IV) for colorectal cancers and the Kaplan-Mei er method were used to determine survival curves. Results Of the 177 patients, 5 were excluded for not having adenocarcinomas . Twenty-five patients (14.5%) had conversion to open surgery; most of thes e patients had rectal cancer or tumor invasion to adjacent organs. Twelve p atients were lost to follow-up. All 135 remaining patients had follow-up. O verall, 28 deaths occurred during the follow-up period, 15 of which were ca ncer-related. The median follow-up was 24 months for patients with stage I, II, and III disease and 9 months for patients with stage IV disease. Obser ved 2-year survival rates were 100% stage I, 88.7% stage II, 80.6% stage II I, and 28.6% stage IV. Survival rates at 4 years were 100% stage I, 79.5% s tage 11, 53.7% stage III, and 0% stage IV. No trocar site recurrence was ob served. Conclusions Early survival curves for patients with colorectal cancer who u nderwent LR do not differ negatively from historical controls for conventio nal surgery. Further validation is needed.