Laparoscopic colectomy survival benefit for colon cancer: is evidence from a randomized trial true?

摘要

To the Editor:Can the laparoscopic approach improve survival of patients with colon cancer? This is a crucial question for thousands of patients and many physicians in the industrialized world. It is well-known that the laparoscopic approach improves the quality of life in the early postoperative period. But, its impact on long-term clinical outcomes is controversial. Lacy et al in the July 2008 issue of the Annals of Surgery report on a randomized trial and conclude that laparos-copy-assisted colectomy (LAC) as compared with open colectomy (OC) for nonmetastatic colon cancer significantly improves recurrence-free and overall survival. Given the major clinical implications of this finding, if it is true, we would like to comment on whether this is a robust conclusion or, due to potential biases, this finding can be interpreted as a chance occurrence.