Laparoscopy is a safe and effective treatment for colon cancer. However, its effects on short- and long-term health outcomes and medical utilization are not fully elucidated. A recent study led by Dr. Ming-Chin Yang, professor at the Institute of Health Policy and Management at National Taiwan University College of Public Health, demonstrated that colon cancer patients received laparoscopy surgery had better short- and long-term outcomes compared to those received open surgery. This study was published in Current Medical Research and Opinion and was co-authored by Dr. Chia-Hui Elise Tan, a graduate from the institute.
In Taiwan, colon cancer is the third most commonly diagnosed cancer and the third leading cause of cancer-related death, after lung and liver cancer. In order to examine the long term effectiveness of laparoscopic surgery, this study linked three population based data including Taiwan Cancer Registry, National Health Insurance claims, and Death Registry to follow the performance of patients for up to 1 year after surgery. Patients aged 18 and older with colon cancer between 2009-2012 were included in the study.
Among the 11,269 colon cancer patients who underwent colectomy, 3,236 (28.72 percent) received laparoscopy and 8,033 (71.28percent) underwent open surgery. Patients received laparoscopic surgery had better overall survival (HR=0.82; [95 percent CI: 0.70-0.97]). These patients also had lower 30-day mortality (0.44 percent vs 0.91 percent), lower 1-year mortality (2.83 percent vs 4.68 percent), lower overall occurrence of complications (6.168 percent) vs 8.778 percent), shorter mean length of stay (12.53 vs 14.93 day), and lower cost for index hospitalization (US$4325.34 vs US$4453.90). No significant differences were observed in medical utilization over a period of 1 year after the surgery.
In conclusion, this study demonstrates that, in both the short- and long-term post-operation, laparoscopic surgery reduced the likelihood of postoperative complications, 30-day, and 1-year mortality while no more expensive than open surgery for colon cancer.
Source: Elise Chia-Hui Tan, Ming-Chin Yang & Chien-Chih Chen (2018) Effects of laparoscopic surgery on survival, quality of care and utilization in patients with colon cancer: a population-based study, Current Medical Research and Opinion, 34:9, 1663-1671, DOI: 10.1080/03007995.2018.1484713