Surgical resection of T4 colon cancers: an NCDB propensity score-matched analysis of open, laparoscopic, and robotic app
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ORIGINAL ARTICLE
Surgical resection of T4 colon cancers: an NCDB propensity score‑matched analysis of open, laparoscopic, and robotic approaches Salvatore A. Parascandola1 · Michael L. Horsey1 · Salini Hota2 · Andrew D. Sparks3 · Mayou Martin T. Tampo4 · George Kim5 · Vincent Obias6 Received: 12 June 2020 / Accepted: 19 October 2020 © Springer-Verlag London Ltd., part of Springer Nature 2020
Abstract Historically, T4 tumors of the colon have been a contraindication to minimally invasive resection. The purpose of this study was to conduct a National Cancer Database analysis to compare the outcomes after curative treatment for T4 colon cancer between robotic, laparoscopic, and open approaches. The US National Cancer Database was queried for patients with T4 adenocarcinoma of the colon who underwent curative resection. Groups were separated based on approach (open, laparoscopic, robotic). One to one nearest neighbor propensity score matching (PSM) ± 1% caliper was performed across surgical approach cohorts to balance potential confounding covariates. Kaplan–Meier estimation and Cox-proportional hazards regression were used to analyze primary outcome of survival. Secondary outcomes were analyzed by way of logistic regression. Inclusion criteria and PSM identified 876 cases per treatment approach (n = 2628). PSM provided adequate discrimination between treatment cohorts (0.6
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