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

Andrew M. McCombie; Frank Frizelle; Philip Frederick Bagshaw; Chris M. Frampton; Peter J. Hewett; Paul John McMurrick; Nicholas Rieger; Michael J. Solomon; Andrew R. Stevenson; on behalf of the ALCCaS Trial group

doi:10.1097/DCR.0000000000001165

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

Andrew M. McCombie, Frank Frizelle, Philip Frederick Bagshaw, Chris M. Frampton, Peter J. Hewett, Paul John McMurrick, Nicholas Rieger, Michael J. Solomon, Andrew R. Stevenson, on behalf of the ALCCaS Trial group

Surgery Alfred Hospital

Research output: Contribution to journal › Article › Research › peer-review

50 Citations (Scopus)

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.

Original language	English
Pages (from-to)	1156-1162
Number of pages	7
Journal	Diseases of the Colon and Rectum
Volume	61
Issue number	10
DOIs	https://doi.org/10.1097/DCR.0000000000001165
Publication status	Published - 1 Oct 2018

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SDG 3 Good Health and Well-being

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10.1097/DCR.0000000000001165

Cite this

McCombie, A. M., Frizelle, F., Bagshaw, P. F., Frampton, C. M., Hewett, P. J., McMurrick, P. J., Rieger, N., Solomon, M. J., Stevenson, A. R., & on behalf of the ALCCaS Trial group (2018). The ALCCaS Trial: A Randomized Controlled Trial Comparing Quality of Life Following Laparoscopic Versus Open Colectomy for Colon Cancer. Diseases of the Colon and Rectum, 61(10), 1156-1162. https://doi.org/10.1097/DCR.0000000000001165

@article{370108bdc27a40268a66244233ebcc66,

title = "The ALCCaS Trial: A Randomized Controlled Trial Comparing Quality of Life Following Laparoscopic Versus Open Colectomy for Colon Cancer",

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.",

author = "McCombie, \{Andrew M.\} and Frank Frizelle and Bagshaw, \{Philip Frederick\} and Frampton, \{Chris M.\} and Hewett, \{Peter J.\} and McMurrick, \{Paul John\} and Nicholas Rieger and Solomon, \{Michael J.\} and Stevenson, \{Andrew R.\} and \{on behalf of the ALCCaS Trial group\}",

year = "2018",

month = oct,

day = "1",

doi = "10.1097/DCR.0000000000001165",

language = "English",

volume = "61",

pages = "1156--1162",

journal = "Diseases of the Colon and Rectum",

issn = "0012-3706",

publisher = "Lippincott Williams \& Wilkins",

number = "10",

}

McCombie, AM, Frizelle, F, Bagshaw, PF, Frampton, CM, Hewett, PJ, McMurrick, PJ, Rieger, N, Solomon, MJ, Stevenson, AR & on behalf of the ALCCaS Trial group 2018, 'The ALCCaS Trial: A Randomized Controlled Trial Comparing Quality of Life Following Laparoscopic Versus Open Colectomy for Colon Cancer', Diseases of the Colon and Rectum, vol. 61, no. 10, pp. 1156-1162. https://doi.org/10.1097/DCR.0000000000001165

The ALCCaS Trial: A Randomized Controlled Trial Comparing Quality of Life Following Laparoscopic Versus Open Colectomy for Colon Cancer. / McCombie, Andrew M.; Frizelle, Frank; Bagshaw, Philip Frederick et al.
In: Diseases of the Colon and Rectum, Vol. 61, No. 10, 01.10.2018, p. 1156-1162.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - The ALCCaS Trial

T2 - A Randomized Controlled Trial Comparing Quality of Life Following Laparoscopic Versus Open Colectomy for Colon Cancer

AU - McCombie, Andrew M.

AU - Frizelle, Frank

AU - Bagshaw, Philip Frederick

AU - Frampton, Chris M.

AU - Hewett, Peter J.

AU - McMurrick, Paul John

AU - Rieger, Nicholas

AU - Solomon, Michael J.

AU - Stevenson, Andrew R.

AU - on behalf of the ALCCaS Trial group

PY - 2018/10/1

Y1 - 2018/10/1

N2 - 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.

AB - 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.

UR - https://www.scopus.com/pages/publications/85053316650

U2 - 10.1097/DCR.0000000000001165

DO - 10.1097/DCR.0000000000001165

M3 - Article

C2 - 30192324

AN - SCOPUS:85053316650

SN - 0012-3706

VL - 61

SP - 1156

EP - 1162

JO - Diseases of the Colon and Rectum

JF - Diseases of the Colon and Rectum

IS - 10

ER -

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

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