Background: Colorectal cancer (CRC) is a leading cause of mortality worldwide and in the UK. Surgical resection is the main curative treatment modality available and using a laparoscopic vs. an open approach may have a direct influence on the inflammatory response, influencing cancer biology and potentially the recurrence kinetics by promoting cancer growth. Methods: This systematic review aims to compare laparoscopic with open surgery for the treatment of colon cancer with a specific focus on the moment of the recurrence. We included randomised controlled trials in intended curative surgery for colon cancer in adults. Interventions: Studies investigating laparoscopic vs. open resection as an intended curative treatment for patients with confirmed carcinoma of the colon. The two co-primary outcomes were the time to recurrence and the overall survival (OS) and disease-free survival (DFS) at three and five years. Meta-analyses were done on the mean differences. Results: After selection, we reviewed ten randomised controlled trials. Most of the trials did not display a statistically significant difference in either DFS or OS at three or at five years when comparing laparoscopic to open surgery. Groups did not differ for the OS and DFS, especially regarding the time needed to observe the median recurrence rate. The quality of evidence (GRADE) was moderate to very low. Conclusion: We observed no difference in the recurrence kinetics, OS or DFS at three or five years when comparing laparoscopic to open surgery in colon cancer.
Bibliographical noteFunding Information:
No paper reported any conflicts of interest. Seven reported no external funding. The COST trial received a number of grants from the National Cancer Institute  and the COLOR trial received funding from Ethicon Endo‐surgery and the Swedish Cancer Foundation . Neither corporation influenced initiation, design or any other aspect of the study.
4 Independent Researcher, supported by the European Society of Anaesthesiology and Intensive Care Mentorship Programme, B‐1000 Brussels, Belgium; firstname.lastname@example.org
- Colon cancer
- Laparoscopic surgery
- Open surgery
- Recurrence kinetics