Authors' objectives:

This study aims to summarise the available evidence on conventional surgery versus laparoscopy in colon cancer.

Authors' results and conclusions: In 80% of the cases, treatment consists in surgical resection of the primary tumor. It has been stated that the laparoscopic approach could be an alternative in certain patients. It is considered that the potential advantages of the laparoscopic approach could be the lower immunosuppression it causes compared to conventional surgery, impacting on survival as it reduces recurrence and presents a shorter post-surgery recovery period. Not all the tumors could be potential candidates to laparoscopic surgery, its use has not been tested yet and it is not considered as a therapeutic alternative in the following: - Location in the transverse colon. - Rectal cancer (tumor lowest border less than 15 cm from the dentate line) - Severe local involvement resulting in a difficult laparoscopic approach. - Stage IV (Dukes D).

Authors' recommendations: Despite its potential advantages, the scientific evidence published so far is not conclusive. In December, 2000, the United Kingdom's National Institute for Clinical Excellence (NICE) evaluated the usefulness of the laparoscopic approach in colon cancer and concluded that it was not better than the traditional approach and proposed to use this strategy only within the context of controlled clinical trials so as to determine its efficacy. In August, 2003, NICE had to review this decision but after consultation with experts and as no new concluding scientific evidence was available, the revision date was postponed until new findings from clinical trials currently in progress are obtained by the year 2005. After the NICE report, only two randomized clinical trials explored the results of laparoscopic surgery compared to traditional surgery and only one of them reports long-term results (global survival, disease-free survival and cancer death). These study findings do not allow to be conclusive about long-term effects of the laparoscopic surgery. In general, it is considered that there is not enough scientific evidence as to recommend the use of laparoscopic surgery rather than traditional surgery beyond the context of controlled clinical trials.

Authors' methods: Overview

Project Status: Completed

URL for project: http://www.iecs.org.ar/

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Argentina

Organisation Name: Institute for Clinical Effectiveness and Health Policy

Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA

Contact Name: info@iecs.org.ar

Contact Email: info@iecs.org.ar

Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)