Introduction In recent years, the laparoscopic surgery for locally advanced colon cancer spread rapidly owing to the clinical trials in the world. Meanwhile, it is difficult to distinguish T4a and T4b in operations and the safety of laparoscopic surgery for T4 colon cancer is still not established. We validated the safety and the usefulness of laparoscopic surgery for T4 sigmoid colon cancer.
Method The study group comprised 67 patients who underwent laparoscopic surgery for pT4 sigmoid colon cancer from 2005 through 2013, excluding ones with distant metastasis. There are 41 male patients (61.2%) and 26 female patients (38.8%). The mean age was 62 years old. pStages were II in 29 patients (43.3%), IIIB in 26 patients (38.8%), and IIIC in 12 patients (17.9%), respectively. The median follow-up was 60 months (14–122). We report short and long-term clinical outcomes.
Results The operation time was 210 min (129–345). The blood loss was 10 ml (5–310). The postoperative hospital stay was 7 days (4–278). 66 patients (98.5%) were able to undergo R0 surgical resection. The suture failure occurred in 4 patients (6%), who underwent ileostomy. The 5-year and final recurrence-free survival (RFS) rates were 61.7% and 61.7%, respectively. Twenty-four patients (35.8%) had recurrence, and initial recurrence occurred in the peritoneum (n = 7), para-aortic region (n = 6), lung (n = 6), liver (n = 5), locoregional region (n = 5), and ovary (n = 1). The 5-year and final overall survival (OS) rates were 90.4% and 73.5%. Nine patients (13.4%) died of cancer progression.
Conclusion Laparoscopic surgery for T4 sigmoid colon cancer provided good postoperative short-term outcomes. On the other hand, recurrence rates were slightly higher and there is still room for improvement in the long-term outcomes.
Disclosure of interest None Declared.