Evidence map›Paper›PMID 34508549›Full record

ArticleThe British journal of surgery2021

Permanent stoma rates after anterior resection for rectal cancer: risk prediction scoring using preoperative variables.

E Back, J Häggström, K Holmgren, M M Haapamäki, P Matthiessen, J Rutegård, M Rutegård

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07369531 (The Impact of Two-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis on Stoma-free Survival in Low Rectal Anal-preserving Surgery), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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.

NCT07369531 narecruitingnot on this mapstarted 2026, after this paper: background citation

The Impact of Two-Stage Turnbull-Cutait Pull-Through Coloanal Anastomosis on Stoma-free Survival in Low Rectal Anal-preserving Surgery: A Multicenter Randomized Controlled Trial (FIAS)

TypeinterventionalSponsorThe First Hospital of Jilin UniversityRan2026 to 2031Enrolled520ConditionsRectal Cancer, Surgical Anastomosis, Survival , Tumor, Anal FunctionArmsTurnbull-Cutait anastomosis, LAR
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Watch and Wait Approach for Rectal Cancer.Journal of clinical medicine · 2023
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

E BackDepartment of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.
J HäggströmDepartment of Statistics, Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden.
K HolmgrenDepartment of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.ORCID 0000-0002-8611-1304
M M HaapamäkiDepartment of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.
P MatthiessenDepartment of Surgery, Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden.
J RutegårdDepartment of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.
M RutegårdDepartment of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden.ORCID 0000-0002-0974-6373

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA permanent stoma after anterior resection for rectal cancer is common. Preoperative counselling could be improved by providing individualized accurate prediction modelling.

methodsPatients who underwent anterior resection between 2007 and 2015 were identified from the Swedish Colorectal Cancer Registry. National Patient Registry data were added to determine presence of a stoma 2 years after surgery. A training set based on the years 2007-2013 was employed in an ensemble of prediction models. Judged by the area under the receiving operating characteristic curve (AUROC), data from the years 2014-2015 were used to evaluate the predictive ability of all models. The best performing model was subsequently implemented in typical clinical scenarios and in an online calculator to predict the permanent stoma risk.

resultsPatients in the training set (n = 3512) and the test set (n = 1136) had similar permanent stoma rates (13.6 and 15.2 per cent). The logistic regression model with a forward/backward procedure was the most parsimonious among several similarly performing models (AUROC 0.67, 95 per cent c.i. 0.63 to 0.72). Key predictors included co-morbidity, local tumour category, presence of metastasis, neoadjuvant therapy, defunctioning stoma use, tumour height, and hospital volume; the interaction between age and metastasis was also predictive.

conclusionUsing routinely available preoperative data, the stoma outcome at 2 years after anterior resection for rectal cancer can be predicted fairly accurately.

Indexed as

RegistriesAgedAged, 80 and overColectomyFemaleHumansMaleMiddle AgedPrognosisRectal NeoplasmsRetrospective StudiesSurgical StomasSweden

Identifiers

PMID34508549
PMCPMC10364873

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.