---
title: "Laparoscopic vs Open Resection for Noncurable Stage IV Colon Cancer: 3-Year JCOG1107 Results"
id: "pubmed-42461618"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42461618"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42461618/"
doi: "10.1097/DCR.0000000000004373"
published_at: "2026-09-23T00:24:14.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Laparoscopic vs Open Resection for Noncurable Stage IV Colon Cancer: 3-Year JCOG1107 Results
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42461618
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42461618/)
- **DOI:** [10.1097/DCR.0000000000004373](https://doi.org/10.1097%2FDCR.0000000000004373)
- **Published At:** 2026-09-23T00:24:14.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- JCOG1107 was a multicenter, open-label, randomized phase III noninferiority trial comparing **laparoscopic surgery** with **open surgery** for primary tumor resection in symptomatic, noncurable stage IV colon cancer. - Eligibility required pathologically confirmed adenocarcinoma or adenosquamous carcinoma of the colon (cecum to rectosigmoid) with stenosis and/or bleeding and 1–3 noncurable metastatic factors. - The trial randomized 195 patients: 95 to open surgery and 100 to laparoscopic surgery. Postoperative chemotherapy was given to 82 patients in the open group and 86 in the laparoscopic group. - The planned sample size was 194 to provide 70% power, one-sided alpha 5%, and a noninferiority hazard ratio margin of 1.38 for the primary end point. - The primary end point was **progression-free survival** (PFS); the median follow-up for all randomized patients was 24.4 months. - Three‑year PFS rates were 5.3% (95% CI, 2.0–11.0) for open surgery and 3.0% (95% CI, 0.8–7.8) for laparoscopic surgery. The hazard ratio (HR) for PFS was 1.028 (95% CI, 0.772–1.370); noninferiority p = 0.02, supporting noninferiority of laparoscopic resection. - Three‑year overall survival (OS) rates were 31.5% (95% CI, 22.5–41.0) after open surgery and 28.5% (95% CI, 20.0–37.6) after laparoscopic surgery (HR 1.048; 95% CI, 0.780–1.410). - Grade 3 or higher late postoperative complications were rare: 1 patient (1.1%) in the open group and 2 patients (2.0%) in the laparoscopic group. - Chemotherapy regimens used postoperatively included modified oxaliplatin, 5‑fluorouracil, and folinic acid plus **bevacizumab**, or capecitabine plus oxaliplatin with **bevacizumab**. - A limitation reported was that chemotherapy was administered without knowledge of microsatellite instability or **RAS/BRAF** mutation status. - Conclusion: At three years, **laparoscopic surgery** was noninferior to **open surgery** for PFS in symptomatic, noncurable stage IV colon cancer and is an acceptable surgical option.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 23. # Three-Year Follow-up of the Randomized Trial Comparing Open Versus Laparoscopic Surgery for Primary Tumor Resection in Patients With Noncurable Stage IV Colon Cancer (JCOG1107) [Akio Shiomi](https://pubmed.ncbi.nlm.nih.gov/?term=Shiomi+A&cauthor_id=42461618)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-1 "Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan."), [Tomonori Akagi](https://pubmed.ncbi.nlm.nih.gov/?term=Akagi+T&cauthor_id=42461618)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-2 "Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan."), [Riku Kajikawa](https://pubmed.ncbi.nlm.nih.gov/?term=Kajikawa+R&cauthor_id=42461618)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-3 "JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan."), [Hiroshi Katayama](https://pubmed.ncbi.nlm.nih.gov/?term=Katayama+H&cauthor_id=42461618)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-3 "JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan."), [Junki Mizusawa](https://pubmed.ncbi.nlm.nih.gov/?term=Mizusawa+J&cauthor_id=42461618)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-3 "JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan."), [Takumi Hasegawa](https://pubmed.ncbi.nlm.nih.gov/?term=Hasegawa+T&cauthor_id=42461618)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-2 "Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan."), [Masaaki Ito](https://pubmed.ncbi.nlm.nih.gov/?term=Ito+M&cauthor_id=42461618)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-4 "Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan."), [Jun Watanabe](https://pubmed.ncbi.nlm.nih.gov/?term=Watanabe+J&cauthor_id=42461618)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-5 "Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan."), [Toshifumi Yamaguchi](https://pubmed.ncbi.nlm.nih.gov/?term=Yamaguchi+T&cauthor_id=42461618)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-6 "Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Osaka, Japan."), [Masazumi Okajima](https://pubmed.ncbi.nlm.nih.gov/?term=Okajima+M&cauthor_id=42461618)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-7 "Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan."), [Satoshi Ikeda](https://pubmed.ncbi.nlm.nih.gov/?term=Ikeda+S&cauthor_id=42461618)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-8 "Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan."), [Shunsuke Tsukamoto](https://pubmed.ncbi.nlm.nih.gov/?term=Tsukamoto+S&cauthor_id=42461618)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-9 "Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan."), [Atsuo Takashima](https://pubmed.ncbi.nlm.nih.gov/?term=Takashima+A&cauthor_id=42461618)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-10 "Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan."), [Yukihide Kanemitsu](https://pubmed.ncbi.nlm.nih.gov/?term=Kanemitsu+Y&cauthor_id=42461618)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-9 "Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan."), [Masafumi Inomata](https://pubmed.ncbi.nlm.nih.gov/?term=Inomata+M&cauthor_id=42461618)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#full-view-affiliation-2 "Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.") Affiliations Expand ### Affiliations * 1 Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan. * 2 Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan. * 3 JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan. * 4 Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan. * 5 Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan. * 6 Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Osaka, Japan. * 7 Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan. * 8 Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan. * 9 Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan. * 10 Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. * PMID: **42461618** * DOI: [ 10.1097/DCR.0000000000004373 ](https://doi.org/10.1097/dcr.0000000000004373) Item in Clipboard Clinical Trial # Three-Year Follow-up of the Randomized Trial Comparing Open Versus Laparoscopic Surgery for Primary Tumor Resection in Patients With Noncurable Stage IV Colon Cancer (JCOG1107) Akio Shiomi et al. Dis Colon Rectum. 2026. Show details Display options Display options Format Abstract PubMed PMID Dis Colon Rectum Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Dis+Colon+Rectum%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Dis+Colon+Rectum%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42461618/) . 2026 Oct 1;69(10):2473-2483. doi: 10.1097/DCR.0000000000004373. Epub 2026 Sep 23. ### Authors [Akio Shiomi](https://pubmed.ncbi.nlm.nih.gov/?term=Shiomi+A&cauthor_id=42461618)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-1 "Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan."), [Tomonori Akagi](https://pubmed.ncbi.nlm.nih.gov/?term=Akagi+T&cauthor_id=42461618)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-2 "Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan."), [Riku Kajikawa](https://pubmed.ncbi.nlm.nih.gov/?term=Kajikawa+R&cauthor_id=42461618)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-3 "JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan."), [Hiroshi Katayama](https://pubmed.ncbi.nlm.nih.gov/?term=Katayama+H&cauthor_id=42461618)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-3 "JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan."), [Junki Mizusawa](https://pubmed.ncbi.nlm.nih.gov/?term=Mizusawa+J&cauthor_id=42461618)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-3 "JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan."), [Takumi Hasegawa](https://pubmed.ncbi.nlm.nih.gov/?term=Hasegawa+T&cauthor_id=42461618)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-2 "Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan."), [Masaaki Ito](https://pubmed.ncbi.nlm.nih.gov/?term=Ito+M&cauthor_id=42461618)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-4 "Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan."), [Jun Watanabe](https://pubmed.ncbi.nlm.nih.gov/?term=Watanabe+J&cauthor_id=42461618)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-5 "Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan."), [Toshifumi Yamaguchi](https://pubmed.ncbi.nlm.nih.gov/?term=Yamaguchi+T&cauthor_id=42461618)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-6 "Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Osaka, Japan."), [Masazumi Okajima](https://pubmed.ncbi.nlm.nih.gov/?term=Okajima+M&cauthor_id=42461618)[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-7 "Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan."), [Satoshi Ikeda](https://pubmed.ncbi.nlm.nih.gov/?term=Ikeda+S&cauthor_id=42461618)[ 8 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-8 "Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan."), [Shunsuke Tsukamoto](https://pubmed.ncbi.nlm.nih.gov/?term=Tsukamoto+S&cauthor_id=42461618)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-9 "Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan."), [Atsuo Takashima](https://pubmed.ncbi.nlm.nih.gov/?term=Takashima+A&cauthor_id=42461618)[ 10 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-10 "Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan."), [Yukihide Kanemitsu](https://pubmed.ncbi.nlm.nih.gov/?term=Kanemitsu+Y&cauthor_id=42461618)[ 9 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-9 "Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan."), [Masafumi Inomata](https://pubmed.ncbi.nlm.nih.gov/?term=Inomata+M&cauthor_id=42461618)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42461618/#short-view-affiliation-2 "Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan.") ### Affiliations * 1 Division of Colon and Rectal Surgery, Shizuoka Cancer Center, Shizuoka, Japan. * 2 Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan. * 3 JCOG Data Center/Operations Office, National Cancer Center Hospital, Tokyo, Japan. * 4 Department of Colorectal Surgery, National Cancer Center Hospital East, Chiba, Japan. * 5 Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan. * 6 Cancer Chemotherapy Center, Osaka Medical and Pharmaceutical University, Osaka, Japan. * 7 Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan. * 8 Department of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan. * 9 Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan. * 10 Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan. * PMID: **42461618** * DOI: [ 10.1097/DCR.0000000000004373 ](https://doi.org/10.1097/dcr.0000000000004373) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background:** JCOG1107 (University Hospital Medical Information Network Clinical Trials Registry, No. UMIN000009715) was a noninferiority phase III trial comparing laparoscopic and open surgery for symptomatic, noncurable stage IV colon cancer. The primary analysis confirmed the noninferiority of laparoscopic surgery in terms of progression-free survival. **Objective:** This study aimed to compare long-term outcomes of laparoscopic and open surgery for stage IV colon cancer. **Design:** Multicenter, open-label, randomized controlled phase III trial. **Setting:** Forty-two Japanese institutions. **Patients:** Participants were considered eligible if they had pathologically confirmed adenocarcinoma or adenosquamous carcinoma with a primary tumor between the cecum and rectosigmoid, presented with stenosis and/or bleeding, and 1 to 3 noncurable factors. The required sample size was 194 to ensure 70% power, a 1-sided alpha of 5%, and a noninferiority HR margin of 1.38. **Interventions:** Patients were randomly assigned to receive either open or laparoscopic primary tumor resection, followed by modified oxaliplatin, 5-FU, and folinic acid plus bevacizumab or capecitabine plus oxaliplatin with bevacizumab. **Main outcome measures:** The primary end point was progression-free survival. **Results:** A total of 195 patients were randomly assigned, including 95 open and 100 laparoscopic surgeries. Postoperative chemotherapy was given to 82 and 86 patients, respectively. The median follow-up period for all randomly assigned patients was 24.4 months. Grade 3 or higher late complications occurred in 1 open (1.1%) and 2 laparoscopic (2.0%) patients. Three-year progression-free survival rates were 5.3% (95% CI, 2.0-11.0) for open surgery and 3.0% (0.8-7.8) for laparoscopic surgery (HR 1.028; 95% CI, 0.772-1.370; p value for noninferiority = 0.02). The 3-year overall survival rates were 31.5% (22.5-41.0) and 28.5% (20.0-37.6; HR 1.048; 95% CI, 0.780-1.410), respectively. **Limitations:** Chemotherapy was administered without knowledge of microsatellite instability or RAS / BRAF mutation status. **Conclusions:** Laparoscopic surgery is noninferior to open surgery for noncurable stage IV colon cancer in terms of progression-free survival and should be considered an acceptable surgical option. See Video Abstract . **Seguimiento a tres aos del ensayo aleatorizado que compara la ciruga abierta con la laparoscpica para la reseccin del tumor primario en pacientes con cncer de colon en estadio iv no curable jcog:** ANTECEDENTES:JCOG1107 (UMIN-CTR, número UMIN000009715) fue un ensayo de fase I
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