5-year results show keyhole bowel cancer surgery is safe and effective

November 4, 2010

Laparoscopic or 'keyhole' surgery is a safe, effective way of removing bowel tumours and should be offered to all patients undergoing surgery for colorectal cancer, according to researchers from the University of Leeds.

Patients who have laparoscopic spend less time in hospital and recover more quickly from the operation. Now long-term follow-up data has confirmed that this way of doing surgery does not make patients with colorectal cancer more vulnerable to the disease returning, as some had feared. And overall survival rates for are just the same as those for conventional, open surgery, researchers concluded after tracking the progress of patients for five years.

The results are the latest from the CLASICC trial - a multicentre study funded by the Medical Research Council that involved around 400 patients with and another 400 with rectal cancer. The trial drew on patients from 27 hospitals across the UK and unlike other head-to-head assessments of these two surgical techniques, included a detailed analysis of all tissue samples that were removed to assess the quality of surgery.

Initial results from the study, published previously, showed that keyhole surgery was as safe as open surgery for colorectal cancer and that in the short term the cancer was no more likely to return. These findings contributed to the decision by the UK National Institute of Clinical Excellence (NICE) and European regulators to back the use of laparoscopic techniques by surgeons for the treatment of colon and bowel cancers.

However, some surgeons were concerned that the minimally invasive technique would not be as good at removing all from tissue around the tumour and that after a few years, the cancer would simply come back. This risk was thought to be highest for patients with rectal cancer.

These latest findings show that this is not the case and that in the hands of an experienced surgeon, the chance of colorectal cancer recurring does not depend on the surgical method. Also, the overall survival rate of patients with colorectal cancer is not affected by the type of surgery they have. Full details are published in the November issue of the British Journal of Surgery.

"There is still a body of surgeons who are sceptical about laparoscopic colorectal cancer surgery and particularly laparoscopic rectal surgery. These long-term follow-up results should now help to convince any remaining sceptics that the minimally invasive technique is safe and effective for most patients with colorectal cancer," said David Jayne, Senior Lecturer in Surgery at the University of Leeds and lead author of the paper.

"Patients too should be reassured that any short-term gains from minimally invasive surgery have not been at the expense of compromised long-term outcomes," he said. "Where suitable, laparoscopic surgery should now be offered to all patients with colorectal cancer so that they can benefit from the recognised advantages, such as quicker recovery, shorter hospital stay and earlier return to normal function."

"Surgery remains the most important of the methods of treatment of bowel cancer and this study confirms that tumours can be removed equally well by keyhole surgery as by standard surgery. We must, however, continue to strive for surgical excellence through audit of both types of surgery and by exploration of new techniques, such as robotic surgery," said Professor Phil Quirke, Yorkshire Cancer Research Centenary Professor of Pathology at the University of Leeds, and co-author of the paper.

More information: DG Jayne et al, 'Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer', British Journal of Surgery, 97(11), November 2010, is available online at www.bjs.co.uk/view/0/currentissue.html

Related Stories

Recommended for you

Targeted antibiotic use may help cure chronic myeloid leukaemia

September 19, 2017
The antibiotic tigecycline, when used in combination with current treatment, may hold the key to eradicating chronic myeloid leukaemia (CML) cells, according to new research.

Brain powered: Increased physical activity among breast cancer survivors boosts cognition

September 19, 2017
It is estimated that up to 75 percent of breast cancer survivors experience problems with cognitive difficulties following treatments, perhaps lasting years. Currently, few science-based options are available to help. In ...

Researchers compose guidelines for handling CAR T cell side effects

September 19, 2017
Immune-cell based therapies opening a new frontier for cancer treatment carry unique, potentially lethal side effects that provide a new challenge for oncologists, one addressed by a team led by clinicians at The University ...

Bone marrow protein a 'magnet' for passing prostate cancer cells

September 19, 2017
Scientists at the University of York have shown that a protein in the bone marrow acts like a 'magnetic docking station' for prostate cancer cells, helping them grow and spread outside of the prostate.

Brain cancer breakthrough could provide better treatment

September 19, 2017
A new discovery about the most common type of childhood brain cancer could transform treatment for young patients by enabling doctors to give the most effective therapies.

A new paradigm for treating transcription factor-driven cancers

September 18, 2017
In the current issue of Proceedings of the National Academy of Sciences, researchers from Nationwide Children's Hospital describe a new paradigm for treating transcription factor-driven cancers. The study focuses on Ewing ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.