Korean J Clin Oncol.  2019 Dec;15(2):72-78. 10.14216/kjco.19014.

Mucinous carcinoma is a predictive factor for the risk of open conversion from laparoscopic colectomy in colorectal cancer

• Seo AJ
• Shin JK
• Park YA
• Huh JW
• Cho YB
• Kim HC
• Yun SH
• Lee WY

• KMID: 2470669
• DOI: http://doi.org/10.14216/kjco.19014

Abstract

PURPOSE
Although laparoscopic surgery is widely accepted in the treatment of colorectal cancer, conversion to open surgery is associated with the rate of unfavorable outcomes. The aim of this study was to determine the factors associated with open conversion from laparoscopic surgery for colorectal cancer.
METHODS
A total of 3,002 patients who underwent laparoscopic colectomy as an initial plan for the treatment of colorectal cancer located from the sigmoid colon to the rectum were retrospectively evaluated between January 2009 and December 2018 at Samsung Medical Center in Korea. Risk factors significantly associated with open conversion were determined using univariate and multivariate regression models.
RESULTS
Among the 3,002 patients, open conversion was performed in 120 patients (4%). Age >60 years (adjusted odds ratio [AOR], 2.370), preoperative bowel obstruction (AOR, 2.348), clinical T4 stage (AOR, 2.201), and serum carcinoembryonic antigen level >5 ng/mL (AOR, 2.289) were significantly associated with open conversion. Moreover, mucinous carcinoma was a significantly more frequent histopathologic type than adenocarcinoma (10.0% vs. 3.2%, P<0.001) in the open conversion group with an AOR of 2.549 (confidence interval, 1.259-5.159; P=0.009).
CONCLUSION
The present study presented a novel finding, i.e. mucinous carcinoma as the histopathologic type could be an independent predictive factor for conversion from laparoscopic colectomy to open surgery. Identifying patients with mucinous carcinoma will help stratify the risk of open conversion preoperatively.

Keyword

Laparoscopic surgery; Colorectal neoplasms; Open conversion; Mucinous carcinoma

MeSH Terms

Adenocarcinoma
Adenocarcinoma, Mucinous*
Carcinoembryonic Antigen
Colectomy*
Colon, Sigmoid
Colorectal Neoplasms*
Conversion to Open Surgery
Humans
Korea
Laparoscopy
Mucins*
Odds Ratio
Rectum
Retrospective Studies
Risk Factors
Carcinoembryonic Antigen
Mucins