Imperial College London
Alternate

Alex Bottle

Faculty of Medicine, School of Public Health

Professor of Medical Statistics
 
 
 
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Contact

 

+44 (0)20 7594 0913robert.bottle Website

 
 
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Location

 

3 Dorset Rise, London EC4Y 8ENCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Askari:2016:10.1007/s00464-015-4686-8,
author = {Askari, A and Nachiappan, S and Currie, A and Bottle, A and Athanasiou, T and Faiz, O},
doi = {10.1007/s00464-015-4686-8},
journal = {Surgical Endoscopy},
title = {Selection for laparoscopic resection confers a survival benefit in colorectal cancer surgery in England.},
url = {http://dx.doi.org/10.1007/s00464-015-4686-8},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - INTRODUCTION: Laparoscopic surgery is being increasingly used in colorectal cancer resections. The aim of this national study was to determine whether laparoscopy confers a long-term survival advantage in colorectal cancer. METHODS: A national administrative data set (Hospital Episode Statistics-HES) encompassing all elective hospital admissions in England between 2001 and 2011 was analysed. All patients that had a colorectal cancer resection (open or laparoscopic) were identified. Cox hazard regression was used to determine differences in overall survival (10 year) between the open and laparoscopy groups. RESULTS: A total of 141,682 patients underwent elective surgery for colorectal cancer, of which 20.9 % (n = 29,550) had a laparoscopic procedure. The median 5-year survival in the open group was 36.1 months compared with 46.1 months in the laparoscopic group (p = <0.001). Survival analysis demonstrated laparoscopy to be an independent predictor of survival. Patients who underwent laparoscopic resection were 18 % less likely to die than patients who had an open CRC resection (HR 0.82, CI 0.79-0.83, p < 0.001). This survival benefit persisted even when initial post-operative mortality (90 day) was excluded (HR 0.87, CI 0.85-0.90, p < 0.001). Subgroup analysis, exploring the effect of CRC laparoscopic surgery on survival in the elderly (>79 years old), demonstrated similar survival benefit amongst patients treated using laparoscopy (HR 0.90, CI 0.86-0.94, p < 0.001). Patients not undergoing adjuvant chemotherapy were more likely to survive if they underwent laparoscopic resection (HR 0.81, CI 0.78-0.83, p < 0.001). Similarly, patients undergoing adjuvant chemotherapy demonstrated a survival benefit if a minimal access surgical approach was utilised (HR 0.86, CI 0.81-0.91, p < 0.001). CONCLUSION: Laparoscopy confers a survival benefit, irrespec
AU  - Askari,A
AU  - Nachiappan,S
AU  - Currie,A
AU  - Bottle,A
AU  - Athanasiou,T
AU  - Faiz,O
DO  - 10.1007/s00464-015-4686-8
PY  - 2016///
SN  - 0930-2794
TI  - Selection for laparoscopic resection confers a survival benefit in colorectal cancer surgery in England.
T2  - Surgical Endoscopy
UR  - http://dx.doi.org/10.1007/s00464-015-4686-8
ER  -
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