Colon cancer spread excised in minimally invasive procedure

CHICAGO – In cases where colon cancer has spread to the liver, curative treatment to excise the metastases using laparoscopic surgery appears to be as successful as open surgery after 5 years of follow-up, researchers reported here.

Of the 147 patients treated with open surgery, 57% were alive at 5 years compared with 56% of 133 patients who underwent laparoscopy (P=0.91), reported Asmund Fretland, MD, a surgeon at Oslo University Hospital.

In a press conference at the 55th annual meeting of the American Society of Clinical Oncology, Fretland noted that laparoscopy to eliminate the liver metastases is a technically challenging procedure and in the current study was performed at centers for excellence.

He reported that recurrence-free survival at 5 years was achieved in 31% of the patients who had open surgery and in 29% of patients who underwent laparoscopy (P=0.73), which was also not statistically significant.

“Laparoscopic liver surgery not only had a lower rate of post-operative complications, an improved quality of life and was cost-effective, compared to open liver surgery, it also had life expectancies that are similar to open surgery,” Fretland said.

In commenting on the study, ASCO expert and surgeon Nancy Baxter, MD, chief of general surgery at St. Michael’s Hospital, Toronto, said, “This study is the first to show that laparoscopic surgery is just as effective long-term as open surgery for patients undergoing removal of colorectal cancer that has spread to the liver, which should give patients confidence when choosing between these options. The experience of your surgeon with these techniques is the key.”

In the study, patients were treated between 2010 and 2016, and liver laparoscopy procedures had been performed more than 400 times by the surgeons before the study was conducted, Fretland said. He said that 19% of the laparoscopic patients experienced post-operative complications compared with 31% of the patients who had open surgery. Patients undergoing the laparoscopic procedure spent about 2 days in hospital; the open surgery patients spent about 4 days in hospital.



Fretland disclosed relevant relationships with Olympus Medical Systems.

Baxter disclosed no relevant relationships with industry.



Fretland A, et al “Long-term survival after laparoscopic versus open resection for colorectal liver metastases,” ASCO 2019; Abstract LBA3516.


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