Evidence map›Paper›PMID 33544250›Full record

ArticleSurgical endoscopy2022

Oncological outcome after local treatment for early stage rectal cancer.

Caroline D M Witjes, Abhilashaben S Patel, Aniruddh Shenoy, Stephen Boyce, James E East, Christopher Cunningham

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 4 pooled it
1.3field-weighted citation impact, top 18% of its field
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

10 citing papers in PubMed, 4 syntheses or guidelines pooled it, 21 citations in OpenAlex.

  1. Pooled it
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  5. Article
  6. Review
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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

6 authors at 3 institutions in 1 country.

Caroline D M WitjesDepartment of Colorectal Surgery, Churchill Hospital, Oxford University Hospital, NHS Foundation Trust, Old Road, Headington, OX3 7LE, Oxford, UK. caroline.witjes@ouh.nhs.uk.
Abhilashaben S PatelDepartment of Colorectal Surgery, Churchill Hospital, Oxford University Hospital, NHS Foundation Trust, Old Road, Headington, OX3 7LE, Oxford, UK.
Aniruddh ShenoyDepartment of Colorectal Surgery, Churchill Hospital, Oxford University Hospital, NHS Foundation Trust, Old Road, Headington, OX3 7LE, Oxford, UK.
Stephen BoyceDepartment of Colorectal Surgery, Churchill Hospital, Oxford University Hospital, NHS Foundation Trust, Old Road, Headington, OX3 7LE, Oxford, UK.
James E EastTranslational Gastroenterology Unit, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.
Christopher CunninghamDepartment of Colorectal Surgery, Churchill Hospital, Oxford University Hospital, NHS Foundation Trust, Old Road, Headington, OX3 7LE, Oxford, UK.
University of Oxford · GBChurchill Hospital · GBOxford BioMedica (United Kingdom) · GB

Funding

Department of Health
6 · The paper itself

Abstract

backgroundTreatment of early rectal cancer is evolving towards organ-preserving therapy which includes endoscopic resection and transanal approaches. We aimed to explore the role of local treatments such as endoscopic polypectomy (Endoscopic Mucosal Resection (EMR) or Endoscopic submucosal dissection (ESD)) and transanal endoscopic microsurgery/ transanal minimal invasive surgery (TEM/TAMIS) in patients who had early rectal cancer. We considered these outcomes alongside conventional major surgery using total mesorectal excision (TME) for early stage disease.

methodsAll patients identified at MDT with early stage rectal cancer at our institution between 2010 and 2019 were included. Long-term outcomes in terms of local recurrence, survival and procedure-specific morbidity were analysed.

resultsIn total, 536 patients with rectal cancer were identified, of which 112 were included based on their pre-operative identification at the MDT on the basis that they had node-negative early rectal cancer. Among these, 30 patients (27%) had the lesion excised by flexible endoscopic polypectomy techniques (EMR/ESD), 67 (60%) underwent TEM/TAMIS and 15 (13%) had major surgery. There were no differences in patient demographics between the three groups except for TEM/TAMIS patients being more likely to be referred from another hospital (p < 0.001) and they were less active (WHO performance status p = 0.04). There were no significant differences in overall survival rates and cancer-specific survival between the three treatment groups. The 5-year overall survival rate for endoscopic polypectomy, TEM/TAMIS or major resection was 96% versus 90% and 88%, respectively (p = 0.89). The 5- year cancer-specific survival rate was 96%, versus 96% and 100%, respectively (p = 0.74).

conclusionEndoscopic polypectomy by EMR/ESD is an appropriate local treatment for early stage rectal cancer in selected patients. It is possible to achieve good oncological outcomes with a polypectomy similar to TEM/TAMIS and major surgery; however, a multidisciplinary approach is necessary enabling close surveillance and the use of adjuvant radiotherapy.

Indexed as

Endoscopic Mucosal ResectionRectal NeoplasmsTransanal Endoscopic MicrosurgeryHumansNeoplasm Recurrence, LocalRadiotherapy, AdjuvantRectumTreatment OutcomeEarly rectal cancerLocal treatmentPolypectomy (EMR/ESD)TAMISTEM

Identifiers

PMID33544250
PMCPMC8741713
OpenAlexW3126551512

What OpenQuestion holds

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LicenceCC BY
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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.