Oncological outcomes of laparoscopic surgery in locally advanced rectal cancer: in a Peruvian institution

López-Cutipa E.F.; Mederos L.B.; Miyagui R.T.S.; Alvarado-Ortiz E.; Auris-Mora H.; Jauregui J.S.; Chiroque-Benites L. · Anales de la Facultad de Medicina (2026) · DOI: 10.15381/anales.v87i1.32723

Resumen

Introduction. Laparoscopic surgery represents a safe approach and not inferior oncologically to open surgery in the treatment of locally advanced rectal cancer (LARC). Objectives: To evaluate the oncological outcomes at 5 years after laparoscopic treatment of locally advanced rectal cancer; and to explore the survival behavior according to clinical, surgical, and pathological variables. Methods: Retrospective cohort study with exploratory analysis in patients with LARC of the middle and lower thirds who underwent neoadjuvant therapy and laparoscopic surgery at the Guillermo Almenara National Hospital (2017-2020). Overall survival (OS) and disease-free survival (DFS) at 5 years were estimated using the Kaplan-Meier method. Results: Thirty patients were included, with a median followup of 79.7 months. The involved circumferential resection margin (CRM) was 6.7%; the rate of severe complications was 13.3%, with no perioperative mortality. The 5-year overall survival (OS) was 70%, and the disease-free survival (DFS) was 79.4%. Non-sphincter-preserving surgery and pathological stage II-III showed trends toward lower OS and DFS rates. Tumor deposits, an involvement of the CRM, and carcinoembryonic antigen (CEA) > 5 ng/mL at diagnosis showed a lower rate of DFS. Conclusions: Laparoscopic TME following neoadjuvant therapy shows long-term OS and DFS outcomes consistent with international standards. Variables such as pathological stage, non-sphincter-preserving surgery, CEA, MRC, and tumor deposits allow the identification of subgroups with a less favorable distribution of events. © (2026), (Universidad Nacional Mayor de San Marcos, Facultad de Medicina), All Rights Reserved.