Evidence map›Paper›PMID 31309324›Full record

ArticleInternational journal of colorectal disease2019

Laparoscopic surgery for rectal cancer reveals comparable oncological outcome even in context of worse short-term results-long-term analysis of nearly 500 patients from two high-volume centers.

Markus Zimmermann, Susanne Merkel, Klaus Weber, Hans-Peter Bruch, Werner Hohenberger, Tobias Keck, Robert Grützmann

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in International journal of colorectal disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Markus ZimmermannDepartment of Surgery, Medical University Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Susanne MerkelDepartment of Surgery, University Hospital, Friedrich-Alexander-University Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany.
Klaus WeberDepartment of Surgery, University Hospital, Friedrich-Alexander-University Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany.
Hans-Peter BruchDepartment of Surgery, Medical University Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
Werner HohenbergerDepartment of Surgery, University Hospital, Friedrich-Alexander-University Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany.
Tobias KeckDepartment of Surgery, Medical University Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany. tobias.keck@uksh.de.ORCID http://orcid.org/0000-0001-7651-6183
Robert GrützmannDepartment of Surgery, University Hospital, Friedrich-Alexander-University Erlangen, Krankenhausstraße 12, 91054, Erlangen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLarge randomized controlled trials have investigated the oncological value of the laparoscopic approach to colorectal cancer. Mainly, non-inferiority for the laparoscopic approach regarding long-term survival could be shown. Nevertheless, some recent trials revealed inferiority especially due to histopathological quality of specimen or location of the tumor in the rectum. The main objective of this study was to compare two historical patient collectives of specialized centers for either the laparoscopic or the open resection approach, regarding long-term survival and disease progression of rectal cancer according to tumor localization in a retrospective propensity score-matched analysis.

methodsA retrospective analysis, based on two prospectively maintained institutional colorectal cancer databases, was performed. The database of the reference center in Erlangen maintained almost exclusively open operations whereas the database in Lübeck maintained to a vast majority laparoscopic operations. To adjust risk profiles, a 1:1 propensity score matching was performed.

resultsSeven hundred fifty-five patients of both centers (Erlangen, n = 507, Lübeck n = 248) were included. Propensity score matching resulted in two equalized groups with 248 patients. Regarding the postoperative complications, advantages for the open approach were seen. Analyzing the survival data, no differences in disease-free as well as overall survival were shown. Also, no differences in the overall loco-regional recurrence and distant metastasis rate were detected.

conclusionIn centers with adequate expertise, open and laparoscopic procedures result in equivalent oncologic long-term outcomes. Advantages for the open resected group concerning short-term results and complications were detected, due to remarkably low rates of anastomotic leakage.

Indexed as

LaparoscopyAdolescentAdultAgedAged, 80 and overFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm Recurrence, LocalPostoperative ComplicationsProportional Hazards ModelsRectal NeoplasmsTime FactorsTreatment OutcomeLaparoscopic surgeryOpen surgeryPropensity scoreRectal cancerRecurrenceSurvival

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Registered trials

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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.