Trial reportAnnals of surgery2019
Disease-free Survival and Local Recurrence for Laparoscopic Resection Compared With Open Resection of Stage II to III Rectal Cancer: Follow-up Results of the ACOSOG Z6051 Randomized Controlled Trial.
Trial report in Annals of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 206 papers, 8 of them syntheses that pooled it.
What it found
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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
206 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- A systematic review and meta-analysis of preoperative MRI-based pelvimetry in predicting surgical difficulty in rectal cancer: Implications for personalised surgical planning.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2026Pooled it
- Laparoscopic versus open surgery for rectal cancer: individual patient data meta-analysis of the ALaCaRT and Z6051 randomized trials.BJS open · 2026Pooled it
- Peri-operative, oncological and functional outcomes of robotic versus transanal total mesorectal excision in patients with rectal cancer: A systematic review and meta-analysis.Techniques in coloproctology · 2024Pooled it
- Pooled it
- Required distal mesorectal resection margin in partial mesorectal excision: a systematic review on distal mesorectal spread.Techniques in coloproctology · 2023Pooled it
- Comparison of Survival Among Adults With Rectal Cancer Who Have Undergone Laparoscopic vs Open Surgery: A Meta-analysis.JAMA network open · 2022Pooled it
- Mid- and low-rectal cancer: laparoscopic vs open treatment-short- and long-term results. Meta-analysis of randomized controlled trials.International journal of colorectal disease · 2022Pooled it
- Pooled it
- Trial
- Effectiveness of Yiqi Chupi powder for alleviating cancer-related fatigue in patients following colorectal cancer surgery: a randomized controlled trial.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Trial
- Trial
- Feasibility of robotic-assisted surgery in advanced rectal cancer: a multicentre prospective phase II study (VITRUVIANO trial).BJS open · 2024Trial
- Multicenter phase II trial of transanal total mesorectal excision for rectal cancer: preliminary results.Surgical endoscopy · 2023Trial
- Long-term results of a randomized study comparing open surgery and laparoscopic surgery in elderly colorectal cancer patients (Eld Lap study).Surgical endoscopy · 2021Trial
- 2D versus 3D laparoscopic total mesorectal excision: a developmental multicentre randomised controlled trial.Surgical endoscopy · 2019Trial
- Association between technical difficulty and patient prognosis after transanal total mesorectal excision for middle and low rectal cancer: a multicenter cohort study.Surgical endoscopy · 2026Article
- Association of the transanal approach with the accuracy of distal margin achievement in rectal cancer surgery.Surgical endoscopy · 2026Article
- Robotic Beyond Total Mesorectal Excision With Synchronous Perineal Flap Reconstruction: Feasibility and Early Outcomes.The international journal of medical robotics + computer assisted surgery : MRCAS · 2026Article
- Prognostic Impact of Circumferential Resection Margin in Minimally Invasive Surgery for Locally Advanced Rectal Cancer: A Multicenter Prospective Study.Annals of gastroenterological surgery · 2026Article
- Long-term oncologic outcomes after transanal total mesorectal excision: a single-center cohort with a minimum of 5-year follow-up.Surgical endoscopy · 2026Article
146 more citing papers are in PubMed but not listed here.
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Authors and funding
25 authors.
Funding
Abstract
objectiveTo determine the disease-free survival (DFS) and recurrence after the treatment of patients with rectal cancer with open (OPEN) or laparoscopic (LAP) resection.
backgroundThis randomized clinical trial (ACOSOG [Alliance] Z6051), performed between 2008 and 2013, compared LAP and OPEN resection of stage II/III rectal cancer, within 12 cm of the anal verge (T1-3, N0-2, M0) in patients who received neoadjuvant chemoradiotherapy. The rectum and mesorectum were resected using open instruments for rectal dissection (included hybrid hand-assisted laparoscopic) or with laparoscopic instruments under pneumoperitoneum. The 2-year DFS and recurrence were secondary endpoints of Z6051.
methodsThe DFS and recurrence were not powered, and are being assessed for superiority. Recurrence was determined at 3, 6, 9, 12, and every 6 months thereafter, using carcinoembryonic antigen, physical examination, computed tomography, and colonoscopy. In all, 486 patients were randomized to LAP (243) or OPEN (243), with 462 eligible for analysis (LAP = 240 and OPEN = 222). Median follow-up is 47.9 months.
resultsThe 2-year DFS was LAP 79.5% (95% confidence interval [CI] 74.4-84.9) and OPEN 83.2% (95% CI 78.3-88.3). Local and regional recurrence was 4.6% LAP and 4.5% OPEN. Distant recurrence was 14.6% LAP and 16.7% OPEN.Disease-free survival was impacted by unsuccessful resection (hazard ratio [HR] 1.87, 95% CI 1.21-2.91): composite of incomplete specimen (HR 1.65, 95% CI 0.85-3.18); positive circumferential resection margins (HR 2.31, 95% CI 1.40-3.79); positive distal margin (HR 2.53, 95% CI 1.30-3.77).
conclusionLaparoscopic assisted resection of rectal cancer was not found to be significantly different to OPEN resection of rectal cancer based on the outcomes of DFS and recurrence.
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