Laparoscopic vs open resection of pT4 colon cancer: a propensity score analysis of 94 patients.

Aim: Our aim was to compare short- and long-term oncological outcomes between laparoscopic and open colectomy in T4 colon cancer.

Methods: We retrospectively analysed oncological outcomes of 94 patients who underwent surgery between December 2010 and December 2016 for pT4 colon cancer, with propensity score matching. All patients were treated with curative intent, by either laparoscopic or open en bloc resection.

Results: The conversion rate in the laparoscopic group was 17.0%. Blood loss, time to flatus and postoperative hospitalization were significantly less in the laparoscopic group. Postoperative morbidity and mortality within 30 days did not significantly differ between the two groups. R0 resection rates and lymph node harvests were similar between the two groups. At 5 years, laparoscopic outcomes were not inferior to open outcomes (overall survival 56.8% vs 50.2%, P = 0.250; disease-free survival 59.7% vs 41.7%, P = 0.06).

Conclusion: The laparoscopic approach is safe and feasible for pathologically confirmed T4 colon cancer. It results in a faster postoperative recovery.