Evidence map›Paper›PMID 34173121›Full record

SynthesisTechniques in coloproctology2021

The impact of transanal local excision of early rectal cancer on completion rectal resection without neoadjuvant chemoradiotherapy: a systematic review.

R Zinicola, R Nascimbeni, R Cirocchi, G Gagliardi, N Cracco, M Giuffrida, G Pedrazzi, G A Binda

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Techniques in coloproctology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.4field-weighted citation impact, top 35% 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

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Completion Total Mesorectal Excision: A Case-Matched Comparison With Primary Resection.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023
    Article
  5. Article
  6. 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 2 countries.

R ZinicolaGeneral Surgery Unit, University Hospital, Parma, Italy. rzmediterraneo@gmail.com.ORCID 0000-0001-8293-3178
R NascimbeniDepartment Molecular & Translational Medicine, University of Brescia, Brescia, Italy.
R CirocchiGeneral Surgery Unit, University Hospital, Perugia, Italy.
G GagliardiDepartment of Surgery, University of Illinois College of Medicine at Chicago, Chicago, IL, USA.
N CraccoGeneral Surgery Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
M GiuffridaGeneral Surgery Unit, University Hospital, Parma, Italy.
G PedrazziUnit Neuroscience, Department of Medicine and Surgery, Centre of Robust Statistic, University of Parma, Parma, Italy.
G A BindaColorectal Surgery, Biomedical Institute, Genoa, Italy.
University of Parma · ITIllinois College · USOspedale Sacro Cuore Don Calabria · ITUniversity of Brescia · ITUniversity of Perugia · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe impact of transanal local excision (TAE) of early rectal cancer (ERC) on subsequent completion rectal resection (CRR) for unfavorable histology or margin involvement is unclear. The aim of this study was to provide a comprehensive review of the literature on the impact of TAE on CRR in patients without neoadjuvant chemoradiotherapy (CRT).

methodsWe performed a systematic review of the literature up to March 2020. Medline and Cochrane libraries were searched for studies reporting outcomes of CRR after TAE for ERC. We excluded patients who had neoadjuvant CRT and endoscopic local excision. Surgical, functional, pathological and oncological outcomes were assessed. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed.

resultsSixteen studies involving 353 patients were included. Pathology following TAE was as follows T0 = 2 (0.5%); T1 = 154 (44.7%); T2 = 142 (41.2%); T3 = 43 (12.5%); Tx = 3 (0.8%); T not reported = 9. Fifty-three percent were > T1. Abdominoperineal resection (APR) was performed in 80 (23.2%) patients. Postoperative major morbidity and mortality occurred in 22 (11.4%) and 3 (1.1%), patients, respectively. An incomplete mesorectal fascia resulting in defects of the mesorectum was reported in 30 (24.6%) cases. Thirteen (12%) patients developed recurrence: 8 (3.1%) local, 19 (7.3%) distant, 4 (1.5%) local and distant. The 5-year cancer-specific survival was 92%. Only 1 study assessed anal function reporting no continence disorders in 11 patients. In the meta-analysis, CRR after TAE showed an increased APR rate (OR 5.25; 95% CI 1.27-21.8; p 0.020) and incomplete mesorectum rate (OR 3.48; 95% CI 1.32-9.19; p 0.010) compared to primary total mesorectal excision (TME). Two case matched studies reported no difference in recurrence rate and disease free survival respectively.

conclusionsThe data are incomplete and of low quality. There was a tendency towards an increased risk of APR and poor specimen quality. It is necessary to improve the accuracy of preoperative staging of malignant rectal tumors in patients scheduled for TAE.

Indexed as

MesocolonProctectomyRectal NeoplasmsHumansNeoadjuvant TherapyNeoplasm Recurrence, LocalNeoplasm StagingRetrospective StudiesTreatment OutcomeCompletion proctectomyCompletion rectal resectionEarly anterior resectionEarly rectal cancerEarly salvage proctectomySurgical transanal excisionTransanal endoscopic microsurgery

Identifiers

PMID34173121
OpenAlexW3174676613

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.