Abstract Background The oncological benefits of Laparoscopic Complete Mesocolic Excision (LCME) over conventional surgery are often challenged by single‐centre designs, small cohorts or short and incomplete follow‐up. This study aimed to examine the difference in recurrence risk 5 years after surgery and 30‐day postoperative complications before and after a population‐based, multicentre LCME implementation. Method LCME was implemented in the Central Denmark Region, Denmark following a training programme in 2017 for all colon cancer surgeons. Colon cancer patients from before (2015–2016, PRE‐group) and after the implementation (2018–2019, POST‐group) were identified through the Danish Colorectal Cancer Group Database. Recurrence 5 years after surgery was ascertained through national registers using a validated algorithm. The Aalen‐Johansen estimator for competing risk was used to calculate cumulative incidence of recurrence. Results A total of 1919 patients (PRE, n = 1024; POST, n = 895) underwent curative‐intended surgery in the study period. The 5‐year cumulative incidence of recurrence was 16.1% (95% CI: 13.8, 18.4) in the PRE group and 12.5% (95% CI: 10.2, 14.9) in the POST group, with a significant absolute risk difference of 3.6% (95% CI: 0.3, 6.9). Furthermore, a significantly lower hazard rate of recurrence was observed in stage II patients after the LCME implementation, with a hazard rate ratio of 0.42 (95% Cl: 0.24, 0.72). Risk of severe postoperative complications was also significantly lower in the POST, compared to the PRE group. Conclusion LCME implementation was associated with a significantly lower risk of recurrence and lower rate of severe postoperative complications. This study indicates that multicentre LCME implementation may improve clinical outcomes without compromising patient safety.
Haug et al. (Sun,) studied this question.