PURPOSE: Laparoscopic surgery for left-sided colon cancer is one of the most frequent procedures performed in laparoscopic colorectal surgery. In this study, we analyzed clinical and long-term oncological outcomes of left-sided colon cancer patients who underwent conventional laparoscopic surgery (CLS) and hand-assisted laparoscopic surgery (HALS).METHODS: A total of 172 CLS patients and 72 HALS patients for left-sided colon cancer from July 2001 to December 2011 were included in this study. The collected data included the clinical and oncological outcomes. We analyzed overall survival and disease-free survival by tumor, node, metastasis (TNM) stage.RESULTS: The mean age of the patients was 64 years, and male patients were predominant. The mean follow-up period was 58.1 months. The number of patients that belong in each TNM stage 0, I, II, III, and IV was as follows: 17 (7%), 47 (19.2%), 70 (28.7%), 80 (32.8%), and 30 (12.3%), respectively. Overall 5-year survival rate for TNM stage I, II, III, and IV was 87.1%, 82.8%, 82%, and 12%, respectively. Overall 5-year survival rate for CLS group and HALS group was 90.2% and 66.7%, 86.5% and 77%, 88.7% and 67.4%, and 18.9% and 0%, respectively. Disease-free 5-year survival rate for TNM stage I, II, and III was 97.7%, 90.7%, and 72.8%, respectively. Disease-free 5-year survival rate for CLS group and HALS group was 97.3% and 100%, 100% and 78.8%, and 81% and 55.1%, respectively.CONCLUSION: These data show the feasibility and safety of laparoscopic surgery for left-sided colon cancer in terms of long-term oncological outcomes.
Colon ; Colonic Neoplasms ; Colorectal Surgery ; Disease-Free Survival ; Follow-Up Studies ; Hand-Assisted Laparoscopy ; Humans ; Laparoscopy ; Male ; Neoplasm Metastasis ; Survival Rate

Purpose: Although protein-induced vitamin K absence or antagonist II (PIVKA-II) has been used as a diagnostic tool for hepatocellular carcinoma (HCC), its prognostic value remains unclear. Methods: This was a nationwide multicenter study using the database of the Korean Liver Cancer Association. Patients with hepatitis B-related HCC who underwent liver resection as the first treatment after initial diagnosis (2008–2014) were selected randomly. Propensity score matching (1:1) was performed for comparative analysis between those with low and high preoperative PIVKA-II. Univariable and multivariable Cox proportional-hazards regression were used to identify prognostic factors for HCC-specific survival. Results: Among 6,770 patients, 956 patients were included in this study. After propensity score matching, the 2 groups (n = 245, each) were well balanced. The HCC-specific 5-year survival rate was 80.9% in the low PIVKA-II group and 78.7% in the high PIVKA-II group (P = 0.605). In univariable analysis, high PIVKA-II (>106.0 mAU/mL) was not a significant predictor for worse HCC-specific survival (hazard ratio [HR], 1.183; 95% confidence interval [CI], 0.76–1.85; P = 0.461). In multivariable analysis, hyponatremia of <135 mEq/L (HR, 4.855; 95% CI, 1.67–14.12; P = 0.004), preoperative ascites (HR, 4.072; 95% CI, 1.59–10.43; P = 0.003), microvascular invasion (HR, 3.112; 95% CI, 1.69–5.74; P < 0.001), and largest tumor size of ≥5.0 cm (HR, 2.665; 95% CI, 1.65–4.31; P < 0.001), but not preoperative high PIVKA-II, were independent predictors for worse HCCspecific survival. Conclusion Preoperative PIVKA-II is not an independent prognostic factor for HCC-specific survival after liver resection for hepatitis B-related HCC.