ArticleAnnals of gastroenterological surgery2022
Japanese multicenter prospective study investigating laparoscopic surgery for locally advanced rectal cancer with evaluation of CRM and TME quality (PRODUCT trial).
Article in Annals of gastroenterological surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Robotic versus laparoscopic approaches for rectal cancer: a systematic review and meta-analysis of postoperative complications, anastomotic leak, and mortality.Langenbeck's archives of surgery · 2024Pooled it
- Feasibility of robotic-assisted surgery in advanced rectal cancer: a multicentre prospective phase II study (VITRUVIANO trial).BJS open · 2024Trial
- Prognostic Impact of Circumferential Resection Margin in Minimally Invasive Surgery for Locally Advanced Rectal Cancer: A Multicenter Prospective Study.Annals of gastroenterological surgery · 2026Article
- Interaction Between Operator and Assistant Certification Is Associated With Local Recurrence After Laparoscopic Rectal Cancer Surgery: An Ancillary Analysis of the EnSSURE Study.Annals of gastroenterological surgery · 2026Article
- Impact of CRM-oriented specimen processing on lymph node retrieval: a prospective multicenter study evaluating the risk of a suboptimal lymph node yield in rectal cancer.Surgery today · 2026Article
- Bony pelvic resection is a risk factor for pelvic abscess after total pelvic exenteration for pelvic malignancies.Surgery today · 2026Article
- First Japanese Experience of Robotic-Assisted Low Anterior Resection Using the da Vinci 5: Incorporating Force Feedback and Case Insights in Rectal Cancer Surgery.Surgical case reports · 2026Article
- Patient-related risk factors for outlet obstruction in diverting loop ileostomy following minimally invasive rectal cancer surgery.Techniques in coloproctology · 2025Article
- A multicentre prospective single-arm clinical trial to evaluate the treatment outcomes of prophylactic laparoscopic lateral pelvic lymph node dissection for advanced lower rectal cancer.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Observational
- Oncological surgical outcomes for colorectal cancer surgery with loco-regional anesthesia: A feasibility study.Saudi medical journal · 2025Article
- My Encounters and Progress with Minimally Invasive Surgery.Juntendo medical journal · 2025Article
- Hybrid Abdominal Robotic Approach Using the hinotori™ Surgical Robot System with Transanal Total Mesorectal Excision for Rectal Cancer: The First Ever Case Report for Rectal Cancer.Journal of the anus, rectum and colon · 2024Article
- World-first report of low anterior resection for rectal cancer with the hinotori™ Surgical Robot System: a case report.Surgical case reports · 2023Article
- Essential updates 2020/2021: Advancing precision medicine for comprehensive rectal cancer treatment.Annals of gastroenterological surgery · 2023Review
- Japanese multicenter prospective study investigating laparoscopic surgery for locally advanced rectal cancer with evaluation of CRM and TME quality (PRODUCT trial).Annals of gastroenterological surgery · 2022Article
Corrections and comments
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Authors and funding
22 authors at 18 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Aim: In Japan, we have not been able to validate the results of laparoscopic surgery for locally advanced rectal cancer using the universal index "circumferential resection margin (CRM)." Previously, we established a semi-opened circular specimen processing method and validated its feasibility. In the PRODUCT trial, we aimed to assess CRM in patients with locally advanced rectal cancer who underwent laparoscopic rectal resection. Methods: This was a multicenter, prospective, observational study. Eligible patients had histologically confirmed rectal adenocarcinoma located at or below 12 cm above the anal verge with clinical stage II or III and were scheduled for laparoscopic or robotic surgery. The primary endpoint was pathological CRM. CRM ≤1 mm was defined as positive. Results: A total of 303 patients operated on between August 2018 and January 2020 were included in the primary analysis. The number of patients with clinical stage II and III was 139 and 164, respectively. Upfront surgery was performed for 213 patients and neoadjuvant therapy for 90 patients. The median CRM was 4.0 mm (IQR, 2.1-8.0 mm), and CRM was positive in 26 cases (8.6%). Univariate and multivariate analyses demonstrated that a predicted CRM from the mesorectal fascia of ≤1 mm on MRI was the significant factor for positive CRM ( Conclusion: This study showed the quality of laparoscopic rectal resection based on the CRM in Japan. Preoperative MRI is recommended for locally advanced rectal cancer to prevent CRM positivity.
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