- A retrospective analysis finds that minimally invasive surgery (MIS) is associated with better safety and survival outcomes than open resection in stage II/III rectal cancer.
Why this matters
- Randomized controlled trials examining open vs minimally invasive techniques in rectal cancer have produced mixed results.
- Retrospective analysis of the National Cancer Database from 2010 to 2015 (N=31,190).
- Funding: NIH.
- 52.8% of cases were open, 47.2% MIS (laparoscopic, 26.2%; laparoscopic converted to open, 4.8%; robotic, 15.0%; robotic converted to open, 1.2%).
- 15.6% of laparoscopic and 7.4% of robotic procedures converted to open.
- After adjustment for patient, tumor, and institutional characteristics, MIS was associated with:
- Lower risk for positive circumferential resection margins: OR, 0.82 (P=.003).
- Greater probability of 12 or more lymph nodes harvested: OR, 1.12 (P=.004).
- MIS also was linked to:
- Lower probability of a ≥7-day hospital stay (P<.001>
- Better OS (HR, 0.90; P=.01).
- Retrospective analysis.