Colon Cancer

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Colectomy for Cancer

Reports on trocar-site recurrences and recurrences on the mini-laparotomy scar afterlaparoscopic colon resection jeopardize the future of this novel mode of treatment for colon cancer. Considering however the significant immediate benefit for the patient, laparoscopic colon resection for cancer is still performed. In order to evaluate the feasibility of this technique as well as its safety 3 questions should be asked.
1. Does laparoscopy increase the risk of parietal metastasis?
2. Is a laparoscopic resection oncologically sufficient?
3. Are recurrence rate and survival different with laparoscopy versus conventional resection?
The answer to these questions seems in favour of the laparoscopic approach. Several studies have demonstrated that the incidence of parietal metastasis is not higher with laparoscopy than with classic resection. Moreover the resection margins after laparoscopic resection seem to be equal or even better than with conventional treatment. The COST study, analysing the 3-year follow-up and comparing it to the National Cancer Institute statistics of colon resection could not find any significant difference between the 2 approaches.
Despite the fact that follow-up is still insufficient, it seems that laparoscopic colectomy is a safe and reliable technique in the treatment of colon cancer. This procedure should however be performed in the context of clinical trials until larger series and longer follow-ups are available.