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当院における結腸癌に対する腹腔鏡手術の長期成績 ; Long-term outcomes of laparoscopic surgery for colon cancer in Shiga University of Medical Science Hospital ; トウイン ニ オケル ケッチョウガン ニ タイスル フククウキョウ シュジュツ ノ チョウキ セイセキ

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Abstract

The aim of this study was to elucidate long-term outcomes of laparoscopic surgery for colon cancer in Shiga University of Medical Science retrospectively. We enrolled 142 patients who were performed laparoscopic surgery to primary colon cancer from 1998 to 2013. The average follow up period was 4.90 years. Tumor was located in Sigmoid colon in 58 patients of those 142 patients. Clinical stage of 103 patients (72%) were cStage I. Notably the accuracy of clinical stage compared to pathological stage was 80% in cStage I, but 45% in cStage II and 25% in cStage IIIa. Recurrences were occurred in 5 patients (Stage II 4 patients, Stage IIIa 1 patient). Primary recurrence site was peritoneal dissemination (1 patient), liver metastasis (2 patients), lung metastasis (1 patients) and local recurrence in retro peritoneum (1 patient). There was no recurrence in port sites. The average period of recurrence was 1.46 year. Five years disease free survival after surgery was 100% in Stage I and 76.1% in Stage II+III. Five year overall survival after surgery was 100% in Stage I and 81.9% in Stage II+III. Long-term outcome indicated that laparoscopic surgery for colon cancer in our hospital could be feasible with favorable long-term results, but it should be noted that high-risk stage II cases including with serosal invasion need intensive treatments including adjuvant chemotherapy. We will continue to perform laparoscopic surgery for colon cancer and monitor short and long-term outcome especially in Stage III advanced cases.