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Dis Colon Rectum. 2018 Oct;61(10):1156-1162. doi: 10.1097/DCR.0000000000001165.

The ALCCaS Trial: A Randomized Controlled Trial Comparing Quality of Life Following Laparoscopic Versus Open Colectomy for Colon Cancer.

Author information

1
Department of Surgery, University of Otago, Christchurch, New Zealand.
2
Department of Medicine, University of Otago, Christchurch, New Zealand.
3
Division of Surgery, The Queen Elizabeth Hospital, Woodville South, Australia.
4
The University of Adelaide Discipline of Surgery, Adelaide, Australia.
5
Department of Surgery, Monash University and Cabrini Hospital, Malvern, Victoria, Australia.
6
Surgical Outcomes Research Centre (SOuRCe), University of Sydney, Australia.
7
Department of Colon and Rectal Surgery, Royal Brisbane & Women's Hospital, Herston, Australia.

Abstract

BACKGROUND:

This study reports the quality-of-life assessment of the ALCCaS trial. The ALCCaS trial compared laparoscopic and open resection for colon cancer. It reported equivalence of survival at 5 years. Quality of life was measured as a secondary outcome.

OBJECTIVE:

This study aimed to report on the quality of life data of the ALCCaS Trial.

DESIGN:

This study reports a randomized controlled trial comparing laparoscopic with open colonic resection.

SETTINGS:

The study was conducted in Australasia.

PATIENTS:

Patients with a single adenocarcinoma of the right, left, or sigmoid colon, presenting for elective treatment, were eligible for randomization.

INTERVENTIONS:

Open and laparoscopic colonic resections were performed.

MAIN OUTCOME MEASURES:

Patient symptoms and quality of life were measured using the Symptoms Distress Scale, the Quality of Life Index, and the Global Quality of Life Score preoperatively, and at 2 days, 2 weeks, and 2 months postoperatively.

RESULTS:

Of the 592 patients enrolled in ALCCaS, 425 completed at least 1 quality-of-life measure at 4 time points (71.8% of cohort). Those who received the laparoscopic intervention had better quality of life postoperatively in terms of the Symptoms Distress Scale (p < 0.01), Quality of Life Index (p < 0.01), and Global Quality of Life (p < 0.01). In intention-to-treat analyses, those assigned to laparoscopic surgery had a better quality of life postoperatively in terms of the Symptoms Distress Scale (p < 0.01) and Quality of Life Index (p < 0.01), whereas Global Quality of Life was not significant (p = 0.056). The subscales better for laparoscopic resection at all 3 postoperative time points were appetite, insomnia, pain, fatigue, bowel, daily living, and health (p < 0.05).

LIMITATIONS:

The primary limitation was the different response rates for the 3 quality-of-life measures.

CONCLUSIONS:

There was a short-term gain in quality of life maintained at 2 months postsurgery for those who received laparoscopic relative to open colonic resection. See Video Abstract at http://links.lww.com/DCR/A691.

PMID:
30192324
DOI:
10.1097/DCR.0000000000001165
[Indexed for MEDLINE]

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