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To the Editor: In a randomized trial of laparoscopic-assisted colectomy (LAC) vs open colectomy for colon cancer, Dr Weeks and colleagues¹ found that LAC offered only minimal benefit in short-term quality of life (QOL).¹ The authors urge surgeons not to perform LAC for colon cancer outside the setting of clinical trials until the long-term outcomes of LAC have been evaluated.

While I agree that surgeons should avoid using LAC for potentially curable colon cancer until equivalence in long-term outcome can be proven, the data of Weeks et al cannot be used to exclude a meaningful QOL benefit for LAC. Their use of the pain distress item from the symptom distress scale (SDS) as a primary outcome measure was a serious flaw, and precluded their ability to find a benefit for any comparison intervention. A change of 0.5 or more in this item (scored 1 to 5) was defined to be . . . [Full Text of this Article]