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A propensity-score-matched analysis of laparoscopic vs open surgery for rectal cancer in a population-based study / P. Manchon-Walsh, L. Aliste, S. Biondo, E. Espin, M. Pera, E. Targarona, N. Pallarès, R. Vernet, J. A. Espinàs, A. Guarga, J. M. Borràs

By: Manchon-Walsh, P [autor].
Contributor(s): Aliste, Luisa | Biondo, S [autor] | Espin, E [autor] | Pera, M [autor] | Targarona, E [autor] | Pallarès, N [autor] | Vernet, Raül [autor].
Material type: materialTypeLabelArticleContent type: text Media type: informàtic Carrier type: recurs en línia Subject(s): Càncer de recte | Laparoscòpia | Professors -- EUITOnline resources: Sol·licitar article a la Biblioteca In: Colorectal Disease. 26 December 2018. doi: 10.1111/codi.14545Summary: Abstract Aim The oncological risk/benefit trade‐off for laparoscopy in rectal cancer is controversial. Our aim was to compare laparoscopic vs open surgery for resection of rectal cancer, using unselected data from the public healthcare system of Catalonia (Spain). Methods This was a multicentre retrospective cohort study of all patients who had surgery with curative intent for primary rectal cancer at Catalonian public hospitals from 2011 to 2012. We obtained follow‐up data for up to 5 years. To minimize the differences between the two groups, we performed propensity score matching on baseline patient characteristics. We used multivariate Cox proportional hazards regression analyses to assess locoregional relapse at 2 years and death at 2 and 5 years. Results Of 1513 patients with Stage I–III rectal cancer, 933 (61.7%) had laparoscopy (conversion rate 13.2%). After applying our propensity score matching strategy (2:1), 842 laparoscopy patients were matched to 517 open surgery patients. Multivariate Cox analysis of death at 2 years [hazard ratio (HR) 0.65, 95% CI 0.48, 0.87; P = 0.004] and 5 years (HR 0.61, 95% CI 0.5, 0.75; P < 0.001) and of local relapse at 2 years (HR 0.44, 95% CI 0.27, 0.72; P = 0.001) showed laparoscopy to be an independent protective factor compared with open surgery. Conclusions Laparoscopy results in lower locoregional relapse and long‐term mortality in rectal cancer in unselected patients with all‐risk groups included. Studies using long‐term follow‐up of cohorts and unselected data can provide information on clinically relevant outcomes to supplement randomized controlled trials.
List(s) this item appears in: Novetats bibliogràfiques. Articles. Gener 2019
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Item type Current location Collection Call number url Status Notes Date due Barcode
Journal article Journal article Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa
Biblioteca
Fitxer informàtic ART-861 (Browse shelf) Not for loan 0001017281536
Journal Journal Escola Universitària d'Infermeria i Teràpia Ocupacional de Terrassa
Internet
En línia Link to resource Not for loan Alguns articles són en accés lliure 0001017285404

Abstract
Aim
The oncological risk/benefit trade‐off for laparoscopy in rectal cancer is controversial. Our aim was to compare laparoscopic vs open surgery for resection of rectal cancer, using unselected data from the public healthcare system of Catalonia (Spain).

Methods
This was a multicentre retrospective cohort study of all patients who had surgery with curative intent for primary rectal cancer at Catalonian public hospitals from 2011 to 2012. We obtained follow‐up data for up to 5 years. To minimize the differences between the two groups, we performed propensity score matching on baseline patient characteristics. We used multivariate Cox proportional hazards regression analyses to assess locoregional relapse at 2 years and death at 2 and 5 years.

Results
Of 1513 patients with Stage I–III rectal cancer, 933 (61.7%) had laparoscopy (conversion rate 13.2%). After applying our propensity score matching strategy (2:1), 842 laparoscopy patients were matched to 517 open surgery patients. Multivariate Cox analysis of death at 2 years [hazard ratio (HR) 0.65, 95% CI 0.48, 0.87; P = 0.004] and 5 years (HR 0.61, 95% CI 0.5, 0.75; P < 0.001) and of local relapse at 2 years (HR 0.44, 95% CI 0.27, 0.72; P = 0.001) showed laparoscopy to be an independent protective factor compared with open surgery.

Conclusions
Laparoscopy results in lower locoregional relapse and long‐term mortality in rectal cancer in unselected patients with all‐risk groups included. Studies using long‐term follow‐up of cohorts and unselected data can provide information on clinically relevant outcomes to supplement randomized controlled trials.

Descripció del recurs: 21 gener 2019

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