SynthesisInternational journal of colorectal disease2015
Oncological outcomes of local excision compared with radical surgery after neoadjuvant chemoradiotherapy for rectal cancer: a systematic review and meta-analysis.
Synthesis in International journal of colorectal disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 5 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Pooled it
- Towards personalized treatment of T2N0 rectal cancer: A systematic review of long-term oncological outcomes of neoadjuvant therapy followed by local excision.Journal of gastroenterology and hepatology · 2022Pooled it
- Comparison of the transanal surgical techniques for local excision of rectal tumors: a network meta-analysis.International journal of colorectal disease · 2020Pooled it
- 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
- Trial
- Organ preservation with local excision or active surveillance following chemoradiotherapy for rectal cancer.British journal of cancer · 2017Trial
- Robotic transanal minimally invasive surgery (r-TAMIS): perioperative and short-term outcomes for local excision of rectal cancers.Surgical endoscopy · 2024Article
- Transanal local excision versus intersphincteric resection for low rectal cancer with stage ypT0-1ycN0 after neoadjuvant chemoradiotherapy: an inverse probability weighting analysis for oncological and functional outcomes.Journal of cancer research and clinical oncology · 2023Article
- Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy.The Cochrane database of systematic reviews · 2023Review
- MRI-based radiomics to predict neoadjuvant chemoradiotherapy outcomes in locally advanced rectal cancer: A multicenter study.Clinical and translational radiation oncology · 2023Article
- Oncologic comparison between nonradical management and total mesorectal excision in good responders after chemoradiotherapy in patients with mid-to-low rectal cancer.Annals of surgical treatment and research · 2021Article
- Multidisciplinary management of elderly patients with rectal cancer: recommendations from the SICG (Italian Society of Geriatric Surgery), SIFIPAC (Italian Society of Surgical Pathophysiology), SICE (Italian Society of Endoscopic Surgery and new technologies), and the WSES (World Society of Emergency Surgery) International Consensus Project.World journal of emergency surgery : WJES · 2021Article
- Local excision following chemoradiotherapy in T2-T3 rectal cancer: current status and critical appraisal.Updates in surgery · 2020Review
- LncRNA ZEB1-AS1 Regulates Colorectal Cancer Cells by MiR-205/YAP1 Axis.Open medicine (Warsaw, Poland) · 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
- Interplay between long noncoding RNA ZEB1-AS1 and miR-101/ZEB1 axis regulates proliferation and migration of colorectal cancer cells.American journal of translational research · 2018Article
- Neoadjuvant therapy and subsequent treatment in rectal cancer: balance between oncological and functional outcomes.Journal of the anus, rectum and colon · 2018Review
- Controversial issues in radiotherapy for rectal cancer: a systematic review.Radiation oncology journal · 2017Review
- Transanal endoscopic microsurgery for rectal cancer: T1 and beyond? An evidence-based review.Surgical endoscopy · 2016Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow rectal cancer is conventionally managed with neoadjuvant chemoradiotherapy (CRT) followed by radical surgery (RS). In patients who refuse a stoma or are unfit for RS, an alternative approach may be the use of pre-op CRT and local excision (LE) where tumours are responsive. The aim of this systematic review is to determine whether differences exist in local recurrence (LR), overall survival (OS) and disease-free (DFS) survival between patients treated with CRT + LE and CRT + RS.
methodsA literature search was performed using MEDLINE/PubMed/Ovid databases and Google Scholar between 1946 and 2013. Studies comparing outcome following LE and RS post-CRT were included. A pooled analysis was carried out using the Mantel-Haenszel statistical (random effects) model to identify differences in LR, OS and DFS between CRT + LE and CRT + RS.
resultsEight studies were suitable for pooled analyses of LR whereas five and four studies were analysed for OS and DFS, respectively. When RS was used as the reference group, LR rate was higher in the LE group. However, this was non-significant (odds ratio (OR) 1.29, confidence interval (CI) 0.72-2.31, p = 0.40). Similarly, no difference was observed in 10-year OS (OR 0.96, CI 0.38-2.43, p = 0.93) or 5-year DFS (OR 1.04, CI 0.61-1.76, p = 0.89). There was evidence of publication bias in studies used for DFS. Subgroup analysis of above outcomes in T3/any N stage cancers showed no difference in LE versus RS.
conclusionIn the current evidence synthesis, there was no statistical difference in the LR, OS and DFS rates observed between patients treated with LE and RS for rectal cancer post-CRT. LE post-CRT may represent a viable alternative to RS for some patients wishing to avoid RS. However, further randomised studies are required to confirm these results.
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Registered trials
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.