Five-year survival for patients with colorectal cancer is equivalent for laparoscopy and laparotomy, suggesting that laparoscopic procedures may become the procedure of choice, according to an article in the April 10th issue of the Lancet.

Colorectal cancer is one of the commonest forms of cancer worldwide. Laparoscopic surgery for colorectal cancer was first introduced a decade ago, although its long-term benefits (5-year survival rates for patients) have not been previously assessed. Ka Lau Leung, MD, and colleagues prospectively compared (over a 10-year period) the effects of laparoscopic and conventional surgery in a randomized trial of around 400 patients with colorectal cancer in the upper rectum or sigmoid colon treated at a hospital in Hong Kong.

5-year survival was similar for patients in both groups (76 percent survival for laparoscopy, 73 percent for conventional surgery, with no statistical difference between the values). The duration of laparoscopic surgery was significantly longer, whereas postoperative recovery time was substantially reduced compared with that seen in patients who were treated with laparotomy. However, laparoscopy was more costly than conventional surgery.

Leung commented, "Laparoscopic resection of rectosigmoid carcinoma does not jeopardize survival and disease control of patients. The justification for adoption of laparoscopic technique would depend on the perceived value of its effectiveness in improving short-term post-operative outcomes."