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A La Cart Research Update

A La Cart Research Update
GICI was pleased to be able to support New Zealand participation in the Australasian Laparoscopic Cancer of the Rectum Trial (ALaCaRT), which compared laparoscopic assisted (or keyhole surgery) with conventional open surgery for the treatment of rectal cancer. The study enrolled 475 patients from Australia and New Zealand and recently reported the preliminary findings based on an assessment of the adequacy or completeness of removal of the cancer. JAMA article click here.

Patients were randomly allocated to either laparoscopic or open surgery with the aim of finding out whether or not laparoscopic surgery was as effective as open surgery at removing the cancer. They found that rates of complete tumour removal, as assessed by pathological examination of the removed specimen, were excellent overall, but lower after laparoscopic than open surgery. The study therefore was not able to prove that laparoscopic surgery was as good as open surgery at obtaining complete tumour removal.

At first impression this may seem like a disappointing result, but there several important messages that we can take from the ALaCaRT trial. The first is that the quality of surgery overall, including the laparoscopic group, was found to be excellent by international standards and this is a common feature of well designed clinical trials; participants tend to receive a very high standard of care. The second message is the importance of clinical trials in determining the role of new treatments, whether these are new drugs or new ways of performing operations. Patients in the ALaCaRT study will continue to be followed up to determine rates of cancer recurrence and long term survival.