Impact of laparoscopic surgery on the long-term outcomes for patients with rectal cancer

Background: This 20-year retrospective study compared the results of laparoscopic surgery with open surgery for patients with rectal cancer to evaluate the impact of laparoscopic surgery on long-term oncological outcomes for rectal cancer. Methods: We analysed survival data collected over 20 years for patients with rectal cancer (n = 407) according to surgical methods and tumour stage between those treated with laparoscopic surgery (n = 272) and those with open surgery (n = 135). Clinical factors were analysed to ascertain possible risk factors that might have been associated with survival from and recurrence of rectal cancer. A multivariate analysis was applied by using Cox's regression model to determine the impact of laparoscopic surgery on long-term oncological outcomes. Results: Overall survival, disease-specific survival and disease-free survival rates were statistically higher in the laparoscopic group than in the open-surgery group. The incidence of local recurrence in the laparoscopic group (7.9%; 95% confidence intervals (CI), 4.2-11.5) was significantly lower than that for the open-surgery group (30.2%; 95% CI, 21.0-39.3; P < 0.001). By using a multivariate analysis, laparoscopic surgery for rectal cancer appeared not to be an independent factor for disease-specific survival or disease-free survival. However, the laparoscopic surgery was an independent factor associated with reduced local recurrence (Hazard ratio (HR), 3.408; 95% CI, 1.890-6.149; P < 0.001). Conclusion: Laparoscopic surgery did not adversely affect the long-term oncological outcome for patients with rectal cancer.