Little Benefit Seen in Laparoscopic Surgery for Colon Cancer

Colon cancer patients who undergo minimally invasive laparoscopic surgery may only benefit slightly over patients who have the more standard open surgery, according to researchers at the Dana-Farber Cancer Institute and the Mayo Clinic.

In a laparoscopic-assisted colectomy, the surgeon accesses the colon through small incisions in the patient's abdomen. A small video-tipped probe and surgical tools are inserted through the incisions. The more traditional surgery, called open colectomy, requires an incision large enough to fully expose the tumor and surrounding tissues.

Researchers developed a study to test the safety and effectiveness of the laparoscopic procedure as well as the quality of life benefit for the patient. The multicenter, randomized controlled study was conducted between September 1994 and February 1999 using 449 patients with colon cancer.

Researchers measured scores on a symptoms distress scale, quality of life index, and global rating scale at 2 days, 2 weeks and 2 months following surgery. The duration of use of postoperative pain medication and length of hospital stay was also recorded.

Researchers found only minimal short-term quality of life benefits in patients having the laparoscopic procedure, according to their report in the Journal of the American Medical Association.

Patients having the laparoscopic procedure used only slightly less pain medication while in the hospital and were sent home an average of one day earlier. In addition, their levels of pain and quality of life immediately after surgery and two months later were the same as patients having an open colectomy, report the investigators.

"These results were certainly a surprise, as it was generally assumed that quality of life after laparoscopic surgery would be substantially better," said Dr. Jane C. Weeks, lead author of the study and director of Dana Farber's Center for Outcomes and Policy Research.

"Although we did see modest advantages for laparoscopic surgery, these findings need to be considered in context," said Weeks. "The goal of colon cancer surgery is to cure the cancer. Until the longer term results of this study are available in a few years, and we know whether laparoscopic surgery is as effective as the standard operation in controlling the cancer, we believe that it should be viewed as experimental and offered only as part of a clinical trial."

Other Sources: Journal of the American Medical Association, Dana Farber Cancer Institute