SynthesisThe British journal of surgery2020
Local recurrence after local excision of early rectal cancer: a meta-analysis of completion TME, adjuvant (chemo)radiation, or no additional treatment.
Synthesis in The British journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07669298 (Active Surveillance vs Adjuvant Chemoradiotherapy for Locally Resected Intermediate-Risk T1 Rectal Cancer), which is not on this map. Cited by 56 papers, 3 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.
Active Surveillance vs Adjuvant Chemoradiotherapy for Locally Resected Intermediate-Risk T1 Rectal Cancer: Multicentre Randomised Controlled Trial
Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Clinical, humanistic and economic burden associated with recurrence among patients with early-stage cancers: a systematic literature review.Frontiers in oncology · 2025Pooled it
- Prior endoscopic resection does not affect the outcome of secondary surgery for T1 colorectal cancer, a systematic review and meta-analysis.International journal of colorectal disease · 2022Pooled it
- The impact of transanal local excision of early rectal cancer on completion rectal resection without neoadjuvant chemoradiotherapy: a systematic review.Techniques in coloproctology · 2021Pooled it
- Trial
- Chemoradiotherapy and transanal endoscopic surgery versus transanal endoscopic surgery alone in T1N0M0 rectal cancer: a multicenter, randomized, controlled, phase III clinical trial (TAUTEM-T1 study).International journal of colorectal disease · 2026Trial
- [Surgery for colorectal cancer in the era of individualized treatment : The new German S3 guideline on colorectal cancer].Chirurgie (Heidelberg, Germany) · 2026Review
- Chinese expert consensus on additional surgery following endoscopic resection for early colorectal cancer (2025 edition).Cancer biology & medicine · 2026Article
- Management of pT1N0M0 rectal cancer: the central role of pathology in therapeutic decisions.International journal of colorectal disease · 2026Article
- Stepwise organ-preserving management of incidental pT1 rectal adenocarcinoma: outcomes after completion transanal endoscopic microsurgery (TEM).Surgical endoscopy · 2026Article
- Consequences of omitting additional treatment after local excision of high-risk early rectal cancer: a national cohort.International journal of colorectal disease · 2026Article
- Long-term outcomes of pT1 rectal cancer after transanal endoscopic surgery: again, a word of caution on high local recurrence - a cohort study.International journal of colorectal disease · 2026Observational
- Oncologic and survival outcomes of pT2N0 rectal adenocarcinoma treated by transanal local excision: a retrospective cohort study.Surgical endoscopy · 2026Article
- Endoscopic Intermuscular Dissection - Short-term Outcomes.Endoscopy international open · 2026Article
- [Technical advances in endoscopic resection : Potential, limits and the necessary interdisciplinary dialogue with surgery].Innere Medizin (Heidelberg, Germany) · 2026Review
- Short-Course Radiotherapy Combined With CapeOx and PD-1 Inhibitor Following Local Excision in High-Risk Early Rectal Cancer: Study Protocol for a Prospective Phase II Trial (TORCH-LE).Clinical Medicine Insights. Oncology · 2026Article
- Assessing the accuracy of magnetic resonance imaging in identifying early rectal cancers suitable for endoscopic intermuscular dissection.Endoscopy · 2025Article
- Early-stage low rectal cancer - re-thinking the standard of care.ANZ journal of surgery · 2025Article
- Quality of Life in Rectal Cancer Treatments: An Updated Systematic Review of Randomized Controlled Trials (2013-2023).Cancers · 2025Review
- Recurrence patterns and management of locally recurrent rectal cancer: a retrospective cohort study.Langenbeck's archives of surgery · 2025Article
- Is tumour location a dominant risk factor of recurrence in early rectal cancer?Surgical endoscopy · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe risks of local recurrence and treatment-related morbidity need to be balanced after local excision of early rectal cancer. The aim of this meta-analysis was to determine oncological outcomes after local excision of pT1-2 rectal cancer followed by no additional treatment (NAT), completion total mesorectal excision (cTME) or adjuvant (chemo)radiotherapy (aCRT).
methodsA systematic search was conducted in PubMed, Embase and the Cochrane Library. The primary outcome was local recurrence. Statistical analysis included calculation of the weighted average of proportions.
resultsSome 73 studies comprising 4674 patients were included in the analysis. Sixty-two evaluated NAT, 13 cTME and 28 aCRT. The local recurrence rate for NAT among low-risk pT1 tumours was 6·7 (95 per cent c.i. 4·8 to 9·3) per cent. There were no local recurrences of low-risk pT1 tumours after cTME or aCRT. The local recurrence rate for high-risk pT1 tumours was 13·6 (8·0 to 22·0) per cent for local excision only, 4·1 (1·7 to 9·4) per cent for cTME and 3·9 (2·0 to 7·5) per cent for aCRT. Local recurrence rates for pT2 tumours were 28·9 (22·3 to 36·4) per cent with NAT, 4 (1 to 13) per cent after cTME and 14·7 (11·2 to 19·0) per cent after aCRT.
conclusionThere is a substantial risk of local recurrence in patients who receive no additional treatment after local excision, especially those with high-risk pT1 and pT2 rectal cancer. The lowest recurrence risk is provided by cTME; aCRT has outcomes comparable to those of cTME for high-risk pT1 tumours, but shows a higher risk for pT2 tumours.
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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.