TY - JOUR AU - Cano-Valderrama,Ó. AU - Cerdán-Santacruz,C. AU - Amillo-Zaragüeta,M. AU - Aurazo,O. AU - González-Prado,C. AU - Cabriada-García,G. AU - Conde-Rodríguez,M. AU - Ramírez-Ruiz,L. AU - Richart-Aznar,J.M. AU - Peris-Tomás,N. AU - Serrano del Moral,Á. AU - Pereira-Pérez,F. AU - Flor-Lorente,B. AU - Biondo,S. AU - Fernández Mancilla,C. AU - López-Tomasetti Fernández,E. AU - González Sánchez,L. AU - Valdés Hernández,J. AU - Pérez Sánchez,A. AU - Pérez González,M. AU - Ramos Bonilla,A. AU - Franco Herrera,R. AU - Alías Jiménez,D. AU - Peña Ros,E. AU - Parra Baños,P.A. AU - Díaz López,C. AU - Concepción Martín,V. AU - Álvarez Sarrado,E. AU - García Borda,F.J. AU - Labalde Martínez,M. AU - Lorenzo Liñán,M. AU - Torres Melero,J. AU - Camacho Dorado,C. AU - Moreno Flores,B. AU - Vicente Rodríguez,I. AU - Fernández Miguel,T. AU - Conde Muíño,R. AU - Segura Jiménez,I. AU - Utrilla Fornals,A. AU - Allué,M. AU - Labarga Rodríguez,F. AU - Asensio Díaz,E. AU - Luna Díaz,M.D.M. AU - Galindo Álvarez,J. AU - Ocaña Jiménez,J. AU - Gómez Sanz,R. AU - Díez Alonso,M. AU - Ochando Cerdán,F. AU - Rueda Orgaz,J.A. AU - Gancedo Quintana,Á. AU - Blanco Terés,L. AU - Arencibia Pérez,B. AU - Artiles Armas,M. AU - Carmona Agúndez,M. AU - Prada,A. AU - Cifrián Canales,I. AU - Turienzo Santos,E. AU - Titos García,A. AU - Carrasco Campos,J. AU - Boldó Roda,E. AU - Mayol Oltra,A. AU - Frago Montanuy,R. AU - Sagarra Cebolla,E. AU - de San Pio Carvajal,E. AU - Dujovne Lindenbaum,P. AU - Obregón Reina,R. AU - Valle Rubio,A. AU - Jiménez Carneros,V. AU - Sánchez Guillén,L. AU - Calero Amaro,A. AU - García Santos,E. AU - Estaire Gómez,M. AU - Pérez Farré,S. AU - Ambrona Zafra,D. AU - Etxart Lopetegi,A. AU - Pascual Damieta,M. AU - Bollo Rodríguez,J. AU - Lora Cumplido,P. AU - Nuño Iglesias,C. AU - de Andrés Asenjo,B. AU - Beltrán de Heredia,J. AU - Balciscueta Coltell,Z. AU - Uribe Quintana,N. AU - Guadalajara Labajo,H. AU - Villarejo,P. AU - Nuñez Fernández,S. AU - Aldrey Cao,I. AU - Moncada Iribarren,E. AU - Taboada Ameneiro,M. AU - Noguera Aguilar,J.F. AU - Blanco Antona,F. AU - Paz Novo,M. AU - Fernández López,F. AU - Jiménez de los Galanes Marchán,S. AU - Rihuete Caro,C. KW - Cancer KW - Colon cancer KW - Laparoscopic surgery KW - Locally advanced colon cancer KW - Minimally invasive surgery KW - Robotic surgery T1 - Is minimally invasive surgery safe and effective for pT4 colon cancer? Results from a national retrospective cohort study LA - eng PY - 2026/// T2 - Surgical Endoscopy SN - 1432-2218 PB - Springer AB - Background: pT4 colon tumors are associated with worse oncologic prognosis. Although minimally invasive surgery (MIS) improves postoperative recovery, concerns remain regarding its long?term oncologic safety. Methods: This is a secondary analysis of a retrospective, multicenter national cohort including patients with pT4 colon cancer treated with curative intent in 50 hospitals. We compared oncologic outcomes (local, peritoneal and systemic recurrence, disease?free survival [DFS] and overall survival [OS]) between open surgery and MIS. Variables associated with surgical approach were incorporated into a propensity score (PS) to adjust outcomes. Results: A total of 1850 patients were analyzed: 725 (39.2%) underwent MIS and 1125 (60.8%) open surgery. Patients selected for MIS more frequently had favorable clinical and tumor characteristics. After PS adjustment, MIS was associated with fewer postoperative complications, including fewer major complications (OR 2.4, p < 0.01). The mean number of resected lymph nodes and margin involvement were similar between groups. After a median follow?up of 42.1 months, overall recurrence rates did not differ between MIS and open surgery, including peritoneal and systemic metastases. Although overall mortality was lower in the MIS group, cancer?specific mortality was similar. MIS was associated with better DFS (HR 1.2, p = 0.018) and OS (HR 1.3, p = 0.024) after adjustment. Conclusions: MIS can be safely performed in well-selected patients with T4 colon cancer—specifically those with ASA I–II, screen-detected disease, right-sided tumors, elective surgery, tumors not adherent to adjacent structures, no need for extended resection, absence of tumor perforation, pT4a stage, and low-grade histology—reducing postoperative complications without compromising oncological outcomes. DO - 10.1007/S00464-026-12833-2 UR - https://portalcientifico.uah.es/documentos/69f8dd39579ceb0ec2bf6198 DP - Dialnet - Portal de la Investigación ER -