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Cancer recurrence following conversion during laparoscopic colorectal resections: a meta-analysis

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Abstract

Introduction

Evidence regarding long-term oncological outcomes following conversion to open surgery (COS) during laparoscopic colorectal resection (LCR) is controversial. The aim of this study is to assess the impact on cancer recurrence of a failed laparoscopic attempt.

Methods

MEDLINE, Scopus and ISI Web of Knowledge databases were searched for articles reporting data on cancer recurrence in patients undergoing completed LCR and COS. Data were pooled by fixed or random effect modeling, according to the presence of heterogeneity. Primary outcomes were local recurrence (LR) and distance recurrence (DR).

Results

Seven studies involving 2493 patients (completed LCR, n 2201 and COS, n 292) were included. The pooled analysis showed that COS resections have an higher risk of LR (OR 1.97, 95% CI 1.14–3.42, p = 0.1); no difference was found in DR (OR 1.09, 95% CI 0.67–1.77, p = 0.71). However, an higher rate of T4 tumor was present in the converted group (OR 2.62, 95% CI 1.71–4, p = 0.0). Subgroup analysis including studies with T stage matched populations showed no significant statistical difference in LR rate; however, a trend toward higher recurrence was still clear.

Conclusion

There is no consistent evidence that a failed laparoscopic attempt does not result in a poorer oncological outcome; therefore, a careful selection of patients for LCR for cancer is required.

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Abbreviations

COS:

Conversion to open surgery

LCR:

Laparoscopic colorectal resection

LR:

Local recurrence

DR:

Distance recurrence

RCTs:

Randomized controlled trials

LCO:

Laparoscopic completed operations

NOS:

Newcaste–Ottawa Scale

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Funding

The authors declare that they have received no funding for the study.

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Authors and Affiliations

  1. Department of Clinical Medicine and Surgery, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy

    Mariano Cesare Giglio, Gaetano Luglio, Viviana Sollazzo, Filomena Liccardo, Roberto Peltrini, Michele Sacco, Giovanni Spiezio, Bruno Amato, Giovanni Domenico De Palma & Luigi Bucci

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  1. Mariano Cesare Giglio
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  2. Gaetano Luglio
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  3. Viviana Sollazzo
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  4. Filomena Liccardo
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  7. Giovanni Spiezio
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  9. Giovanni Domenico De Palma
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  10. Luigi Bucci
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Correspondence to Mariano Cesare Giglio.

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The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.

Human and animal rights

The procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

Informed consent 

This type of study is based on aggregated data of already published studies. Informed consent can not be obtained from patients.

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Giglio, M.C., Luglio, G., Sollazzo, V. et al. Cancer recurrence following conversion during laparoscopic colorectal resections: a meta-analysis. Aging Clin Exp Res 29 (Suppl 1), 115–120 (2017). https://doi.org/10.1007/s40520-016-0674-7

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  • DOI: https://doi.org/10.1007/s40520-016-0674-7

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