Laparoscopic surgery for colon cancer
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Vinzenz Völkel1,2 · Teresa Draeger1,3 · Michael Gerken1 · Monika KlinkhammerSchalke1 · Stefan Benz4 · Alois Fürst2 1
© The Author(s) 2020
Tumorzentrum Regensburg—Institut für Qualitätssicherung und Versorgungsforschung der Universität Regensburg, Regensburg, Germany 2 Klinik für Allgemein-, Viszeral-, Thoraxchirurgie und Adipositasmedizin, Caritas Krankenhaus St. Josef Regensburg, Regensburg, Germany 3 Klinik für Innere Medizin I, Caritas Krankenhaus St. Josef Regensburg, Regensburg, Germany 4 Klinik für Allgemeine, Viszeral- und Kinderchirurgie, Kliniken Böblingen, Böblingen, Germany
Laparoscopic surgery for colon cancer A systematic review with special focus on real-world data Worldwide, laparoscopic surgery is becoming the new standard for curative resection of colon cancer. In recent decades, many studies were performed to analyze its advantages and disadvantages and, above all, its oncologic safety compared to the open technique.
multivariable regression analysis, which needs to be considered when interpreting the corresponding outcomes. This paper is the first systematic review on the topic providing a synthesis of the most important RCTs and relevant retrospective trials, drawing a holistic picture of laparoscopic surgery in colon cancer patients.
Today, there exists quite extensive butalso very heterogenous evidence on laparoscopic colorectal tumor surgery. Many publications are dedicated exclusively to postoperative endpoints such as duration of surgery, resection margins, or shortterm mortality. Others report long-term outcomes including overall survival or recurrence rates. The study designs range from small case studies to large randomized controlled trials (RCTs), which are regarded as the gold standard in medical research. However, due to strict in- and exclusion criteria, RCTs often reflect the situation in a selected patient collective only; therefore, it might not be sufficient to rely exclusively on the findings of RCTs. In contrast to this, large population-based retrospective multicenter or registry-based studies use “real-word data”, offering insight into the efficiency in daily clinical practice. This renders them an indispensable part of the clinical evaluation process. To account for the lack of randomization, such studies employ adequate statistical methods like
Materials and methods To identify relevant literature on the topic, PubMed and Cochrane Central were searched [1, 2]. For this purpose, three fields of interest were defined: 4 Colorectal cancer: the corresponding MeSH term is “Colorectal Neoplasms” Moreover, a free-text search with the following (truncated) terms was performed: “colorectal cancer*”, “colorectal carcinoma*”, “colorectal tumor*”, “colorectal tumour*”, and “colorectal neoplasm*”. Local differences in spelling (e.g., “tumour” instead of “tumor”) were considered. To identify only relevant publications, the search was restricted to publications tagged with the subheading “surgery”. Moreover, the free-text search was limited to the title. In total, 91,597 hits were reached. 4
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