Minimally invasive surgery is underutilized for colon cancer

Celia N. Robinson, G. John Chen, Courtney J. Balentine, Shubhada Sansgiry, Christy L. Marshall, Daniel A. Anaya, Avo Artinyan, Daniel Albo, David H. Berger

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Background: The Clinical Outcomes of Surgical Therapy Group (COST) trial published in 2004 demonstrated that minimally invasive surgery (MIS) for colorectal cancer provided equivalent oncologic results and better short-term outcomes when compared to open surgery. Before this, MIS comprised approximately 3% of colorectal cancer cases. We hypothesized that there would be a dramatic increase in the use of MIS for colon cancer after this publication. Methods: The National Inpatient Sample database was used to retrospectively review MIS and open colon resections from 2005 through 2007. ICD-9-specific procedure codes were used to identify open and MIS colon cancer resections. Statistical analyses performed included Pearson χ2 tests and dependent t tests, and Cramer's V was used to measure the strength of association. Results: A total of 240,446 colon resections were performed between 2005 and 2007. The percentage of resections performed laparoscopically increased from 4.7% in 2005 to 6.7% in 2007 for colon cancer and remained relatively unchanged for benign disease (25.2% in 2005 vs. 27.4% in 2007, P < 0.007). Patients undergoing laparoscopic colectomy were younger, had lower comorbidity scores, had lower rates of complications (20.1 vs. 25.1%, P < 0.001), had shorter lengths of stay (7.2 vs. 9.6 days, P < 0.001), and had lower mortality (1.5 vs. 3.0%, P < 0.001). Furthermore, when evaluating adoption trends, urban teaching hospitals adopted laparoscopy more rapidly than rural nonteaching centers. Conclusions: Adoption of MIS for the treatment of colorectal cancer has been slow. Additional studies to evaluate barriers in the adoption of MIS for colon cancer resection are warranted.

Original languageEnglish (US)
Pages (from-to)1412-1418
Number of pages7
JournalAnnals of Surgical Oncology
Volume18
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

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Minimally Invasive Surgical Procedures
Colonic Neoplasms
Colorectal Neoplasms
Colon
Colectomy
Urban Hospitals
International Classification of Diseases
Group Psychotherapy
Teaching Hospitals
Laparoscopy
Comorbidity
Inpatients
Length of Stay
Databases
Mortality

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Robinson, C. N., Chen, G. J., Balentine, C. J., Sansgiry, S., Marshall, C. L., Anaya, D. A., ... Berger, D. H. (2011). Minimally invasive surgery is underutilized for colon cancer. Annals of Surgical Oncology, 18(5), 1412-1418. https://doi.org/10.1245/s10434-010-1479-0

Minimally invasive surgery is underutilized for colon cancer. / Robinson, Celia N.; Chen, G. John; Balentine, Courtney J.; Sansgiry, Shubhada; Marshall, Christy L.; Anaya, Daniel A.; Artinyan, Avo; Albo, Daniel; Berger, David H.

In: Annals of Surgical Oncology, Vol. 18, No. 5, 01.05.2011, p. 1412-1418.

Research output: Contribution to journalArticle

Robinson, CN, Chen, GJ, Balentine, CJ, Sansgiry, S, Marshall, CL, Anaya, DA, Artinyan, A, Albo, D & Berger, DH 2011, 'Minimally invasive surgery is underutilized for colon cancer', Annals of Surgical Oncology, vol. 18, no. 5, pp. 1412-1418. https://doi.org/10.1245/s10434-010-1479-0
Robinson CN, Chen GJ, Balentine CJ, Sansgiry S, Marshall CL, Anaya DA et al. Minimally invasive surgery is underutilized for colon cancer. Annals of Surgical Oncology. 2011 May 1;18(5):1412-1418. https://doi.org/10.1245/s10434-010-1479-0
Robinson, Celia N. ; Chen, G. John ; Balentine, Courtney J. ; Sansgiry, Shubhada ; Marshall, Christy L. ; Anaya, Daniel A. ; Artinyan, Avo ; Albo, Daniel ; Berger, David H. / Minimally invasive surgery is underutilized for colon cancer. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 5. pp. 1412-1418.
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abstract = "Background: The Clinical Outcomes of Surgical Therapy Group (COST) trial published in 2004 demonstrated that minimally invasive surgery (MIS) for colorectal cancer provided equivalent oncologic results and better short-term outcomes when compared to open surgery. Before this, MIS comprised approximately 3{\%} of colorectal cancer cases. We hypothesized that there would be a dramatic increase in the use of MIS for colon cancer after this publication. Methods: The National Inpatient Sample database was used to retrospectively review MIS and open colon resections from 2005 through 2007. ICD-9-specific procedure codes were used to identify open and MIS colon cancer resections. Statistical analyses performed included Pearson χ2 tests and dependent t tests, and Cramer's V was used to measure the strength of association. Results: A total of 240,446 colon resections were performed between 2005 and 2007. The percentage of resections performed laparoscopically increased from 4.7{\%} in 2005 to 6.7{\%} in 2007 for colon cancer and remained relatively unchanged for benign disease (25.2{\%} in 2005 vs. 27.4{\%} in 2007, P < 0.007). Patients undergoing laparoscopic colectomy were younger, had lower comorbidity scores, had lower rates of complications (20.1 vs. 25.1{\%}, P < 0.001), had shorter lengths of stay (7.2 vs. 9.6 days, P < 0.001), and had lower mortality (1.5 vs. 3.0{\%}, P < 0.001). Furthermore, when evaluating adoption trends, urban teaching hospitals adopted laparoscopy more rapidly than rural nonteaching centers. Conclusions: Adoption of MIS for the treatment of colorectal cancer has been slow. Additional studies to evaluate barriers in the adoption of MIS for colon cancer resection are warranted.",
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AU - Anaya, Daniel A.

AU - Artinyan, Avo

AU - Albo, Daniel

AU - Berger, David H.

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N2 - Background: The Clinical Outcomes of Surgical Therapy Group (COST) trial published in 2004 demonstrated that minimally invasive surgery (MIS) for colorectal cancer provided equivalent oncologic results and better short-term outcomes when compared to open surgery. Before this, MIS comprised approximately 3% of colorectal cancer cases. We hypothesized that there would be a dramatic increase in the use of MIS for colon cancer after this publication. Methods: The National Inpatient Sample database was used to retrospectively review MIS and open colon resections from 2005 through 2007. ICD-9-specific procedure codes were used to identify open and MIS colon cancer resections. Statistical analyses performed included Pearson χ2 tests and dependent t tests, and Cramer's V was used to measure the strength of association. Results: A total of 240,446 colon resections were performed between 2005 and 2007. The percentage of resections performed laparoscopically increased from 4.7% in 2005 to 6.7% in 2007 for colon cancer and remained relatively unchanged for benign disease (25.2% in 2005 vs. 27.4% in 2007, P < 0.007). Patients undergoing laparoscopic colectomy were younger, had lower comorbidity scores, had lower rates of complications (20.1 vs. 25.1%, P < 0.001), had shorter lengths of stay (7.2 vs. 9.6 days, P < 0.001), and had lower mortality (1.5 vs. 3.0%, P < 0.001). Furthermore, when evaluating adoption trends, urban teaching hospitals adopted laparoscopy more rapidly than rural nonteaching centers. Conclusions: Adoption of MIS for the treatment of colorectal cancer has been slow. Additional studies to evaluate barriers in the adoption of MIS for colon cancer resection are warranted.

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