Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted <i>versus</i> open surgery for colorectal cancer

TLDR

The UK Medical Research Council CLASICC trial compared laparoscopically assisted to open surgery for colorectal cancer. The study compared the two surgical approaches and performed exploratory analyses of age groups and the learning curve. Five‑year follow‑up showed no difference in overall or disease‑free survival, local or distant recurrence, or wound/port‑site recurrence between laparoscopic and open surgery, while conversion to open was linked to worse overall survival early, and age or learning curve had no impact, confirming the oncological safety of laparoscopic surgery. Trial registered as ISRCTN74883561 (http://www.controlled‑trials.com).

Abstract

The UK Medical Research Council CLASICC trial assessed the safety and efficacy of laparoscopically assisted surgery in comparison with open surgery for colorectal cancer. The results of the 5-year follow-up analysis are presented.Five-year outcomes were analysed and included overall and disease-free survival, and local, distant and wound/port-site recurrences. Two exploratory analyses were performed to evaluate the effect of age (70 years or less, or more than 70 years) on overall survival between the two groups, and the effect of the learning curve.No differences were found between laparoscopically assisted and open surgery in terms of overall survival, disease-free survival, and local and distant recurrence. Wound/port-site recurrence rates in the laparoscopic arm remained stable at 2.4 per cent. Conversion to open operation was associated with significantly worse overall but not disease-free survival, which was most marked in the early follow-up period. The effect of surgery did not differ between the age groups, and surgical experience did not impact on the 5-year results.The 5-year analyses confirm the oncological safety of laparoscopic surgery for both colonic and rectal cancer. The use of laparoscopic surgery to maximize short-term outcomes does not compromise the long-term oncological results.ISRCTN74883561 (http://www.controlled-trials.com).