Better Oncologic Outcomes with Open vs. Laparoscopic Resection of Rectal Cancer

Randomized, controlled trials have demonstrated comparable oncologic outcomes between laparoscopic and open resection of colon cancers, and laparoscopic resection reduces some types of morbidity. Now, in a randomized, noninferiority, phase III trial involving 475 patients in Australia and New Zealand, researchers have evaluated outcomes of such surgery for rectal cancers.

Successful resection, defined as complete total mesorectal excision, a clear circumferential margin ≥1 mm, and a clear distal resection margin ≥1 mm, was achieved in 82% with laparoscopy and 89% with open surgery. This difference did not meet the prespecified noninferiority margin of −8%. Excluding T4 tumors did not alter the conclusions (successful resection in 83% with la…