Evidence map›Paper›PMID 33712984›Full record

SynthesisAnnals of surgical oncology2021

Neoadjuvant Short-Course Radiotherapy for Upper Third Rectal Tumors: Systematic Review and Individual Patient Data Metaanalysis of Randomized Controlled Trials.

Michael Flanagan, Cillian Clancy, Jan Sorensen, Lindsay Thompson, Elma Meershoek-Klein Kranenbarg, Cornelis J H van de Velde, David Sebag-Montefiore, John Burke

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 30% 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

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. 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

8 authors at 5 institutions in 3 countries.

Michael FlanaganDepartment of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.ORCID http://orcid.org/0000-0003-3925-1512
Cillian ClancyDepartment of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland.
Jan SorensenHealthcare Outcomes Research Centre, Royal College of Surgeons in Ireland (RCSI), Dublin 2, Ireland.
Lindsay ThompsonMedical Research Council Clinical Trial Unit, London, UK.
Elma Meershoek-Klein KranenbargLeiden University Medical Center, Leiden, The Netherlands.
Cornelis J H van de VeldeLeiden University Medical Center, Leiden, The Netherlands.
David Sebag-MontefioreLeeds Cancer Centre, University of Leeds, Leeds, UK.
John BurkeDepartment of Colorectal Surgery, Beaumont Hospital, Dublin 9, Ireland. johnburke@rcsi.com.
Beaumont Hospital · IELeiden University Medical Center · NLMedical Research Council · GBRoyal College of Surgeons in Ireland · IEUniversity of Leeds · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is no consensus on the use of neoadjuvant radiotherapy for tumors of the upper third of the rectum. Due to conflicting findings in high-quality trials and significant long-term side effects associated with neoadjuvant radiotherapy, the benefit of neoadjuvant radiotherapy for upper third rectal tumors is less certain than for lower two third rectal tumors. This metaanalysis compares oncological outcomes with neoadjuvant radiotherapy and surgery versus surgery alone for upper third rectal tumors. PATIENTS AND

methodsPubMed, Embase, and the Cochrane library databases were searched. Randomized controlled trials (RCT) comparing neoadjuvant radiotherapy and surgery versus surgery alone for resectable rectal cancer were included. Individual patient data were sought from the principal investigator of each eligible trial for comparative data on patients with upper third rectal tumors. The main outcomes measured were survival outcomes, oncological outcomes, postoperative morbidity, and late toxicity.

resultsIndividual patient data from two RCTs examining outcomes in 758 patients were obtained. Published data from one further RCT containing comparable data on upper third rectal tumors were included in analysis of local recurrence. In patients with curative surgery, there was no significant reduction in local recurrence or significant improvement in overall survival or disease-free survival with neoadjuvant radiotherapy (LR RR: 0.38, 95% CI 0.14-1.04, p = 0.06) (OS RR: 1.10, 95% CI 0.98-1.24, p = 0.11) (DFS RR: 1.11, 95% CI 0.97-1.26, p = 0.13).

conclusionsThe benefit of neoadjuvant radiotherapy for upper third rectal tumors is not certain, and surgery alone for patients with potentially curative disease at preoperative staging may be sufficient.

Indexed as

Neoadjuvant TherapyRectal NeoplasmsHumansNeoplasm Recurrence, LocalRandomized Controlled Trials as TopicRectum

Identifiers

PMID33712984
OpenAlexW3134690259

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.