Laparoscopic Radical Resection as an Independent Favorable Prognostic Factor for Stage I-III Colon Cancer: A Propensity Score-Matched Study

Background‌: Surgical approach selection critically impacts postoperative morbidity and long-term oncologic outcomes in colorectal cancer management. This study aimed to compare survival benefits between laparoscopic and open radical resection for stage I-III colon cancer, while establishing a validated prognostic prediction model. ‌Methods: ‌Patients with colon cancer who underwent surgery at our hospital were researched in this retrospective study. Propensity score matching (PSM) was used to minimize the preoperative baseline variables. The clinical and pathological data between open and laparoscopic surgery were compared, and the effect of factors on overall survival (OS) was analyzed by the Cox proportional hazard model. Then, a personalized nomogram to predict the patient's prognosis was constructed. Results: A total of 324 colon cancer samples were selected by PSM. Patients in the laparoscopic group had a higher number of lymph node dissections, fewer blood transfusions, and fewer postoperative complications (P<0.05). The 3- and 5-year OS rates were 72% and 60% in the open group, and 82% and 76.8% in the laparoscopic group, respectively (P< 0.05). The preoperative CEA level, pathological T (pT) stage, differentiation, operation mode, lymph node metastasis (LNM), postoperative chemotherapy, and perineural invasion (PNI) were independent predictors of survival (P<0.05). A prognostic model based on these seven factors was constructed. The final nomogram showed excellent discrimination (C=0.796) for OS. ‌Conclusion: Laparoscopic resection demonstrates superior long-term survival compared to open surgery in localized colon cancer. The developed nomogram provides clinically valuable prognostic stratification, potentially guiding postoperative surveillance .