Comparative effectiveness of open versus laparoscopic resection in patients with locally advanced colon cancer - Inverse probability of treatment weighting approach - Research article

Sep 23, 2026

Uploaded by dhado

Study aims to clarify differences between open and laparoscopic colectomy for locally advanced colon cancer in Saudi Arabia and identify factors affecting selection of surgical approach. Patients diagnosed between 2016 and 2021 at National Guard-Health Affairs were analyzed using comparative tests for clinical and descriptive variables and survival models. Among 222 resected cases, laparoscopic colectomy was used in 75 patients; weighted analyses assessed 5-year overall survival and recurrence-free survival through Cox regression.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Epidemiology and staging of colorectal cancer

Rationale for comparing surgical approaches

Methods

Study population and data collection

Statistical analyses and survival estimation

OPEN ACCESS Citation: Alyabsi MS, Alqarni AH, Almutairi AF, Alhalafi MS, Algarni MA, Alshammari KM, et al. (2025) Comparative effectiveness of open versus laparoscopic resection in patients with locally advanced colon cancer: Inverse probability of treatment weighting approach. PLoS One 20(12): e0338741. [https://doi](https://doi). org/10.1371/journal.pone.0338741 Editor: Athanasios G. Pantelis, Athens Medical Group, Psychiko Clinic, GREECE Received: February 10, 2025 Accepted: November 26, 2025 Published: December 29, 2025 Copyright: © 2025 Alyabsi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data availability statement: The dataset for this study is provided as Supporting Information files. Funding: The author(s) received no specific funding for this work. RESEARCH ARTICLE Comparative effectiveness of open versus laparoscopic resection in patients with locally advanced colon cancer: Inverse probability of treatment weighting approach Mesnad S. Alyabsi1,2, Anwar H. Alqarni1,3*, Adel F. Almutairi2,3, Mohammed S. Alhalafi4, Mohammed A. Algarni2,3,5, Kanan M. Alshammari2,3,5, Nahar A. Alselaim2,3,4 1 Population Health Research Section, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia, 2 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, 3 King Abdullah International Medical Research Center, Riyadh, Saudi Arabia, 4 Surgery Department, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia, 5 Oncology Department, Ministry of National Guard -Health Affairs, Riyadh, Saudi Arabia * [Anwarralqarni@gmail.com](Anwarralqarni@gmail.com) Abstract Background In Saudi Arabia, colorectal cancer is one of the most common cancers. Most of colorectal cancer cases were diagnosed at an advanced stage, making the treatment process more challenging. In this paper, we aim to investigate the differences between open and laparoscopic colectomies and factors influencing the use of these approaches in locally advanced colon cancer patients. Methods The study population included patients with locally advanced colon cancer at the National Guard-Health Affairs, Saudi Arabia. Descriptive and clinical data were collected for the patients diagnosed with locally advanced colon cancer from 2016 to 2021. The variables related to the locally advanced colon cancer patients’ characteristics were compared with a chi-square test, Fisher’s exact tests, student’s t-tests, or Wilcoxon tests when appropriate. The overall survival and recurrence-free survival were computed using the Cox regression model. Results Of the 222 patients who underwent tumor resection, 75 (33 .8%) underwent a laparoscopic colectomy. Unlike open colectomy patients, the group with laparoscopic colectomy were younger, had a higher body mass index, and had tumors in the left colon, with ≥12 harvested lymph nodes. The weighted data indicated no difference in the 5-year overall-survival, and the recurrence-free survival between the approaches PLOS One | [https://doi.org/10.1371/journal.pone.0338741](https://doi.org/10.1371/journal.pone.0338741) December 29, 2025 1 / 11 Competing interests: The authors have declared that no competing interests exist. [5-year overall survival, hazard ratio: 0.42, 95%CI (0 . 16, 1. 12); recurrence-free survival, hazard ratio: 0.74, 95%CI (0 .31, 1.78)] . Conclusions No significant differences were observed between laparoscopic and open surgical approach for patients with locally advanced colon cancer. Introduction Colorectal cancer (CRC) is a common malignancy with more than 1.9 million incident cases and 904,000 deaths reported globally in 2022 [ 1] . Prediction studies estimate that the number of cases will increase to 3.2 million by the year 2040 [2] . In 202

FAQs

What is the main research objective of the study?

The study investigates differences between open and laparoscopic colectomies and evaluates factors influencing which approach is used for locally advanced colon cancer patients.

How were outcomes such as survival and recurrence-free survival analyzed?

Overall survival and recurrence-free survival were computed using the Cox regression model, with weighted data used for the comparisons.

What did the study conclude about laparoscopic versus open surgery?

No significant differences were observed between laparoscopic and open surgical approaches for patients with locally advanced colon cancer.

Sep 23, 2026

Uploaded by dhado