Background: This study aimed to evaluate the oncological outcomes of conversion in patients undergoing resection for colon cancer. Methods: Patients with stages I-III colon adenocarcinoma operated on between 2000 and 2012 were included. Oncologic outcomes were assessed by surgical approach (laparoscopy vs. open). A secondary analysis compared patients who required conversion to open vs. laparoscopic only. Results: We identified 1196 patients that met inclusion criteria (28% laparoscopic, 72% open). Overall, 13% of laparoscopic cases were converted to open. There were no differences in 5-year overall survival (OS) (p = 0.258), disease-free survival, (DFS) (p = 0.070), cancer-specific survival (CSS) (p = 0.207), or recurrence (p = 0.216) between laparoscopy and open surgery. However, patients with conversion had a worse OS (p = 0.010) and DFS (p = 0.006) when compared to laparoscopic only. Conclusion: Conversion from laparoscopic to open surgery is a marker for worse survival outcomes. Further investigation is needed to define the underlying cause of these differences.
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