ArticleAnnals of surgery2016
Extralevator Abdominoperineal Excision for Low Rectal Cancer--Extensive Surgery to Be Used With Discretion Based on 3-Year Local Recurrence Results: A Registry-based, Observational National Cohort Study.
Article in Annals of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis 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
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Standard versus extralevator abdominoperineal excision and oncologic outcomes for patients with distal rectal cancer: A meta-analysis.Medicine · 2017Pooled it
- [Surgery for colorectal cancer in the era of individualized treatment : The new German S3 guideline on colorectal cancer].Chirurgie (Heidelberg, Germany) · 2026Review
- Long-term oncological outcomes of extralevator versus standard abdominoperineal resection with 20 years' experience.Updates in surgery · 2026Article
- Extralevator Abdominoperineal Excision Improves Overall Survival Compared to Standard Abdominoperineal Excision: A Systematic Review and Meta-Analysis.Annals of gastroenterological surgery · 2026Article
- MRI navigation surgery for T4b rectal cancer using multiple minimally invasive surgical approaches.International journal of colorectal disease · 2025Article
- Personalized Decisional Algorithms for Soft Tissue Defect Reconstruction after Abdominoperineal Resection for Low-Lying Rectal Cancers.Current oncology (Toronto, Ont.) · 2024Article
- Short- and mid-term outcomes of abdominoperineal resection with perineal mesh insertion: a single-centre experience.International journal of colorectal disease · 2023Article
- Supine bottom-up extralevator abdominoperineal excision for anorectal adenocarcinoma is not inferior to standard approach and may be thus safely performed.Surgical endoscopy · 2023Article
- Safety of robotic surgical management of non-elective colectomies for diverticulitis compared to laparoscopic surgery.Journal of robotic surgery · 2023Article
- Comparison of the clinical efficacy of laparoscopic extralevator abdominoperineal excision (ELAPE) and non-ELAPE for low rectal cancer.Updates in surgery · 2023Article
- Long-term outcomes after extra-levator versus conventional abdominoperineal excision for low rectal cancer.BMC surgery · 2022Article
- Widespread anorectal lymphovascular networks and tissue drainage: analyses from submucosal India ink injection and indocyanine green fluorescence imaging.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021Article
- Postoperative MRI Findings Following Conventional and Extralevator Abdominoperineal Excision in Low Rectal Cancer.Frontiers in surgery · 2021Article
- Extralevator abdominoperineal excision for advanced low rectal cancer: Where to go.World journal of gastroenterology · 2020Review
- Selection and Outcomes in Abdominoperineal Resection.Frontiers in oncology · 2020Review
- Oncological outcomes of abdominoperineal resection for the treatment of low rectal cancer: A retrospective review of a single UK tertiary centre experience.Annals of medicine and surgery (2012) · 2018Article
- Abdominoperineal Resection for Rectal Cancer in the Twenty-First Century: Indications, Techniques, and Outcomes.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2018Review
- Preliminary Outcome of Individualized Abdominoperineal Excision for Locally Advanced Low Rectal Cancer.Chinese medical journal · 2018Article
- Article
- Extralevator versus standard abdominoperineal excision in locally advanced rectal cancer: a retrospective study with long-term follow-up.International journal of colorectal disease · 2018Article
Corrections and comments
- Commented on by
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this prospective registry-based population study was to investigate the efficacy of extralevator abdominoperineal excision (ELAPE) regarding local recurrence rates within 3 years after surgery.
backgroundLocal recurrence of rectal cancer is more common after abdominoperineal excision (APE) than after anterior resection. Extralevator abdominoperineal excision was introduced to address this problem. No large-scale studies with long-term oncological outcomes have been published.
methodsAll Swedish patients operated on with an APE and registered in the Swedish ColoRectal Cancer Registry 2007 to 2009 were included (n = 1397) and analyzed with emphasis on the perineal part of the operation. Local recurrence at 3 years was collected from the registry.
resultsThe local recurrence rates at 3 years [median follow-up, 3.43 years (APE, 3.37 years; ELAPE, 3.41 years; not stated: 3.43 years)] were significantly higher for ELAPE compared with APE (relative risk, 4.91). Perioperative perforation was also associated with an increased risk of local recurrence (relative risk, 3.62). There was no difference in 3-year overall survival between APE and ELAPE. In the subgroup of patients with very low tumors (≤4 cm from the anal verge), no significant difference in the local recurrence rate could be observed.
conclusionsExtralevator abdominoperineal excision results in a significantly increased 3-year local recurrence rate as compared with standard APE. Intraoperative perforation seems to be an important risk factor for local recurrence. In addition to significantly increased 3-year local recurrence rates, the significantly increased incidence of wound complications leads to the conclusion that ELAPE should only be considered in selected patients at risk of intraoperative perforation.
Indexed as
Identifiers
What OpenQuestion holds
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.