ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2013
Practice patterns and long-term survival for early-stage rectal cancer.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
40 citing papers in PubMed, 3 syntheses or guidelines pooled it, 94 citations in OpenAlex.
- Executive Summary of the American Radium Society Appropriate Use Criteria for Local Excision in Rectal Cancer.International journal of radiation oncology, biology, physics · 2019Guideline
- Rectal Cancer, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2018Guideline
- Practice parameters for early rectal cancer management: Italian Society of Colorectal Surgery (Società Italiana di Chirurgia Colo-Rettale; SICCR) guidelines.Techniques in coloproctology · 2015Guideline
- Neoadjuvant Chemotherapy, Excision, and Observation for Early Rectal Cancer: The Phase II NEO Trial (CCTG CO.28) Primary End Point Results.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2023Trial
- Organ preservation for clinical T2N0 distal rectal cancer using neoadjuvant chemoradiotherapy and local excision (ACOSOG Z6041): results of an open-label, single-arm, multi-institutional, phase 2 trial.The Lancet. Oncology · 2015Trial
- Oncologic safety and technical feasibility of completion transanal total mesorectal excision after local excision; a cohort study from the International TaTME Registry.Surgical endoscopy · 2025Article
- Analysis of Risk Factors and Development of a Predictive Model for Prognosis in Early-Stage Rectal Cancer Patients.International journal of general medicine · 2025Article
- Surgical Techniques for Transanal Local Excision for Early Rectal Cancer.Ewha medical journal · 2023Review
- Excision of malignant and pre-malignant rectal lesions by transanal endoscopic microsurgery in patients under 50 years of age.World journal of gastrointestinal surgery · 2023Article
- Lymph node metastasis in T1-2 colorectal cancer: a population-based study.International journal of colorectal disease · 2023Article
- Impact of adequate lymph nodes dissection on survival in patients with stage I rectal cancer.Frontiers in oncology · 2022Article
- Prognostic Factors and Treatment of Recurrence after Local Excision of Rectal Cancer.Yonsei medical journal · 2021Observational
- Lymph Node Positivity in T1/T2 Rectal Cancer: a Word of Caution in an Era of Increased Incidence and Changing Biology for Rectal Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- An evaluation of trans-anal rectoscopic-assisted minimally invasive surgery (ARAMIS): a new platform for transanal surgery.International journal of colorectal disease · 2020Article
- The multidisciplinary management of rectal cancer.Nature reviews. Gastroenterology & hepatology · 2020Review
- Surgical and postoperative evaluations of rectal adenomas excised with a rigid proctoscope.Acta cirurgica brasileira · 2020Article
- Neoadjuvant chemoradiation improves oncologic outcomes in low and mid clinical T3N0 rectal cancers.International journal of colorectal disease · 2020Article
- Survival analysis of local excision vs total mesorectal excision for middle and low rectal cancer in pT1/pT2 stage and intermediate pathological risk.World journal of surgical oncology · 2019Article
- Article
- Can less be more? Organ preservation strategies in the management of rectal cancer.Current oncology (Toronto, Ont.) · 2019Review
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5 authors at 1 institution in 1 country.
Funding
Abstract
purposeStandard of care treatment for most stage I rectal cancers is total mesorectal excision (TME). Given the morbidity associated with TME, local excision (LE) for early-stage rectal cancer has been explored. This study examines practice patterns and overall survival (OS) for early-stage rectal cancer.
methodsAll patients in the National Cancer Data Base diagnosed with rectal cancer from 1998 to 2010 were initially included. Use of LE versus proctectomy and use of adjuvant radiation therapy were compared over time. Adjusted Cox proportional hazards models were used to compare OS based on treatment.
resultsLE was used to treat 46.5% of patients with T1 and 16.8% with T2 tumors. Use of LE increased steadily over time (P < .001). LE was most commonly used for women, black patients, very old patients, those without private health insurance, those with well-differentiated tumors, and those with T1 tumors. Proctectomy was associated with higher rates of tumor-free surgical margins compared with LE (95% v 76%; P < .001). Adjuvant radiation therapy use decreased over time independent of surgical procedure or T stage. For T2N0 disease, patients treated with LE alone had significantly poorer adjusted OS than those treated with proctectomy alone or multimodality therapy.
conclusionGuideline-concordant adoption of LE for treatment of low-risk stage I rectal cancer is increasing. However, use of LE is also increasing for higher-risk rectal cancers that do not meet guideline criteria for LE. Treatment with LE alone is associated with poorer long-term OS. Additional studies are warranted to understand the factors driving increased use of LE.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.