That is the main finding of a seven-year international study, which will be published in the May 13 issue of the New England Journal of Medicine. The study involves 872 patients with colon cancer and is the most extensive comparison to date of the two surgical techniques. It addresses concerns raised in the early 1990s about higher rates of colon cancer recurrence after laparoscopic surgery. Those concerns resulted in policies recommending that laparoscopic colon surgery not be performed until clinical studies showed it was effective in cancer patients.
Heidi Nelson, M.D., a colorectal surgeon at Mayo Clinic, led the study team of 66 colorectal surgeons at 48 medical centers in the United States and Canada. The study team compared rates of complications, cancer recurrence, length of time patients were cancer-free and the overall survival in both sets of patients.
All patients in the study had been diagnosed with potentially curable cancer of the colon. Each patient was randomly assigned to undergo either the minimally invasive laparoscopic procedure or the standard surgery and was afterwards followed for several years to check for cancer recurrence.
"Our study shows that while laparoscopic surgery is safe and effective for treatment of colon cancer, it must be performed selectively," says Dr. Nelson. "It should not be used for patients whose cancer requires extensive surgery to other organs besides the colon, and it should be done by surgeons who are experienced in performing laparoscopic colon surgery."
This year in the United States about 100,000 people will be diagnosed with colon cancer. More than 90 percent of them will be told they need surgery to remove all or part of the colon or large intestin