SynthesisAnnals of surgical oncology2021
Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer: A Systematic Review and Metaanalysis of Oncological and Operative Outcomes.
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. It is linked to trial NCT06097416 (A Phase III, Multi-institutional Randomised Trial Comparing Neoadjuvant Chemoradiotherapy), which is not on this map. Cited by 44 papers, 5 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.
A Phase III, Multi-institutional Randomised Trial Comparing Neoadjuvant Chemoradiotherapy (NARCT) and Total Neoadjuvant Therapy (TNT) in Patients With T3 (a/b/c) Rectal Cancer
Who cites it
44 citing papers in PubMed, 5 syntheses or guidelines pooled it, 88 citations in OpenAlex.
- Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2024 for the treatment of colorectal cancer.International journal of clinical oncology · 2025Guideline
- MRI radiomics prediction modelling for pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review and meta-analysis.Abdominal radiology (New York) · 2025Pooled it
- FDG-PET/MRI in colorectal cancer care: an updated systematic review.Abdominal radiology (New York) · 2025Pooled it
- Treatment of Locally Advanced Rectal Cancer in the Era of Total Neoadjuvant Therapy: A Systematic Review and Network Meta-Analysis.JAMA network open · 2024Pooled it
- The Impact of Neoadjuvant Chemotherapy on the Surgical Management of Colorectal Peritoneal Metastases: A Systematic Review and Meta-Analysis.Annals of surgical oncology · 2022Pooled it
- Total Neoadjuvant Therapy Versus Long-Course Chemoradiotherapy in Locally Advanced Rectal Cancer: Real-World Tumor Response and Clinical Outcomes.Medical sciences (Basel, Switzerland) · 2026Article
- Significance of nodal yield after rectal resection in the TNT era: does count matter?BMC cancer · 2026Article
- Emergency rectal cancer: clinical presentation and therapeutic options.Frontiers in surgery · 2026Article
- International expert Delphi consensus on management of early and locally advanced rectal cancer.International journal of colorectal disease · 2025Article
- The Role of Baseline PET/CT Parameters in Predicting Treatment Response in Patients with Locally Advanced Rectal Cancer Undergoing Total Neoadjuvant Therapy.Medicina (Kaunas, Lithuania) · 2025Article
- A novel structural modeling magnitude and orientation radiomic descriptor for evaluating response to neoadjuvant therapy in rectal cancers via MRI.NPJ precision oncology · 2025Article
- Predicting pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer with two step feature selection and ensemble learning.Scientific reports · 2025Article
- Prognostic Nutritional Index as a Predictor of Surgical Morbidity in Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer.Journal of clinical medicine · 2025Article
- Efficacy and toxicity of neoadjuvant radiotherapy with concomitant dose escalation for rectal cancer.Frontiers in oncology · 2025Article
- First in human intraarterial delivery of tislelizumab for the treatment of pMMR locally advanced rectal cancer: A single-arm, open label, phase II clinical trial.Translational oncology · 2024Article
- Omission of Chemoradiation in Locally Advanced Rectal Adenocarcinoma: Evaluation of PROSPECT in a National Database.Journal of surgical oncology · 2024Article
- Deformable Mapping of Rectal Cancer Whole-Mount Histology with Restaging MRI at Voxel Scale: A Feasibility Study.Radiology. Imaging cancer · 2024Article
- Racial and ethnic disparities in access to total neoadjuvant therapy for rectal cancer.Surgery · 2024Article
- Long-term survival and functional outcomes of laparoscopic surgery for clinical stage I ultra-low rectal cancers located within 5 cm of the anal verge: A prospective phase II trial (Ultimate trial).Annals of surgery · 2024Article
- Enhancing clinical complete response assessment in rectal cancer: integrating transanal multipoint full-layer puncture biopsy criteria: a systematic review.Frontiers in oncology · 2024Review
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTotal neoadjuvant therapy in rectal cancer refers to the administration of chemoradiotherapy plus chemotherapy before surgery. Recent studies have shown improved pathological complete response and disease-free survival with this approach. However, survival benefits remain unproven. Our objective is to present a metaanalysis of oncological outcomes of total neoadjuvant therapy in locally advanced rectal cancer. PATIENTS AND
methodsA comprehensive search was performed on PubMed, Medline, and Google Scholars. Studies comparing total neoadjuvant therapy with standard neoadjuvant chemoradiotherapy were included. Data extracted from the individual studies were pooled and a metaanalysis performed. The outcomes of interest are the rate of complete pathological response, nodal response, resection margin, anal preservation, anastomotic leak, local recurrence, distant recurrence, disease-free survival, and overall survival.
resultsThere were 15 comparative studies with 2437 patients in the neoadjuvant chemoradiotherapy group and 2284 in the total neoadjuvant therapy group. The pooled complete pathological response was 22.3% in the total neoadjuvant therapy group, compared with 14.2% in the standard neoadjuvant chemoradiotherapy group (p < 0.001). Even though there was no difference in local recurrence rate, there was a significantly lower rate of distant recurrence (OR 0.81, p = 0.02), and better 3-year disease-free survival (70.6% vs. 65.3%, respectively, p < 0.001) and overall survival (84.9% vs. 82.3%, respectively, p = 0.006), favoring the total neoadjuvant therapy group. Due to significant heterogeneity in the study protocols, there remains uncertainty on the ideal chemotherapy/radiotherapy sequence.
conclusionsThis study provides supporting evidence on the favorable immediate and intermediate oncological outcomes with the use of total neoadjuvant therapy for locally advanced rectal cancer.
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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.