COLOR (colon cancer)
Trial question
What is the role of laparoscopic colectomy in patients with colon cancer?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
47.0% female
53.0% male
N = 1248
1248 patients (586 female, 662 male).
Inclusion criteria: adult patients with an adenocarcinoma localized in the cecum, ascending colon, descending colon, or sigmoid colon above the peritoneal deflection.
Key exclusion criteria: BMI > 30 kg/m²; adenocarcinoma of the transverse colon or splenic flexure; metastases in the liver or lungs; acute intestinal obstruction; multiple primary tumors of the colon; scheduled for synchronous intra-abdominal surgery.
Interventions
N=627 laparoscopic colectomy (laparoscopic colectomy done by an experienced surgical team).
N=621 open colectomy (open colectomy done by a surgical team with at least one staff member with credentials in colon surgery).
Primary outcome
Median blood loss during surgery
100 mL
175 mL
175.0 mL
131.3 mL
87.5 mL
43.8 mL
0.0 mL
Laparoscopic
colectomy
Open
colectomy
Significant
decrease ▼
Significant decrease in median blood loss during surgery (100 mL vs. 175 mL; AD -75 mL, 95% CI -112.48 to -37.52).
Secondary outcomes
Significant decrease in mean hospital stay (8.2 days vs. 9.3 days; MD -1.1, 95% CI -1.9 to -0.2).
Significantly shorter mean time to first bowel movement (3.6 days vs. 4.6 days; MD -1, 95% CI -1.3 to -0.7).
No significant difference in death (1% vs. 2%; MD -0.7, 95% CI -2.2 to 0.7).
Safety outcomes
No significant difference in overall complications.
Conclusion
In adult patients with an adenocarcinoma localized in the cecum, ascending colon, descending colon, or sigmoid colon above the peritoneal deflection, laparoscopic colectomy was superior to open colectomy with respect to median blood loss during surgery.
Reference
Ruben Veldkamp, Esther Kuhry, Wim C J Hop et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005 Jul;6(7):477-84.
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