Evidence map›Paper›PMID 38605826›Full record

ArticleArchives of internal medicine research2024

Radical versus Local Surgical Excision for Early Rectal Cancer: A Systematic Review and Meta-Analysis.

Sarah El-Nakeep, Samragnyi Madala, Anusha Chidharla, Balarama Krishna Surapaneni, Subhrajit Saha, Benjamin Martin, Anup Kasi

Open access · diamondAbstract read
In one paragraph

Article in Archives of internal medicine research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. SEOM-GEMCAD-TTD clinical guidelines for localized rectal cancer (2025).Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Guideline
  2. Article
  3. Local excision in rectal cancer: When and for whom?World journal of gastrointestinal oncology · 2025
    Article
  4. 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

7 authors at 4 institutions in 2 countries.

Sarah El-NakeepFaculty of Medicine, Ain Shams University, Cairo, Egypt.
Samragnyi MadalaUniversity of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, United States; 52242.
Anusha ChidharlaDivision of Medical Oncology, University of Kansas Cancer Center, 2650 Shawnee Mission Pkwy, Westwood, KS, United States 66205.
Balarama Krishna SurapaneniUniversity of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, United States; 52242.
Subhrajit SahaDivision of Radiation Oncology, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, United States: 66160.
Benjamin MartinDivision of Colorectal Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS, United States: 66160.
Anup KasiDivision of Medical Oncology, University of Kansas Cancer Center, 2650 Shawnee Mission Pkwy, Westwood, KS, United States 66205.
The University of Kansas Cancer Center · USUniversity of Iowa Hospitals and Clinics · USUniversity of Kansas Medical Center · USAin Shams University · EG

Funding

Triterpenoids in mitigation of radiation induced acute or delayed inflammationU01AI170036 · NIAID · UNIVERSITY OF KANSAS MEDICAL CENTER · PI Richard J DiPaolo, John Mark Perry · 2022 to 2026
$3.7M
NIAID NIH HHS U01 AI170036
6 · The paper itself

Abstract

Background: Radical excision (RE) for rectal cancer carries a higher risk of mortality and morbidity, while local excision (LE) could decrease these postoperative risks. However, the long-term benefit of LE is still debatable. Aim: To study the effectiveness of LE versus RE in T1 and T2 rectal cancer. Methods: A systematic review and meta-analysis was conducted using key databases like PubMed and ClinicalTrials.gov. Only cohort studies and randomized controlled trials were included. RevMan 5.4 tool was used for data analysis. Both clinical and statistical heterogeneity of the studies were assessed, and I Results: A total of 18 studies were included for final meta-analysis. Four were RCTs, while the other 15 were retrospective cohort studies. One included study had data from both RCT and non-RCT study groups. Nine studies were multicentered or national studies while nine were unicentral.There was no difference in risk ratio (RR) between OS: RR 0.95, 95% Confidence Interval (CI) [0.91, 0.99] and DFS: RR 0.93, 95% CI [0.87, 1.01]. There were lower hazards ratios in OS: RR 1.41, 95% CI [1.14, 1.74] and DFS: RR 1.95, 95% CI [1.36, 2.78] with radical, as compared to LE. Lower recurrence rate was associated with RE. Random effect model was used due to clinical heterogeneity between studies (different surgical procedures, tumor staging, adjuvant chemo or radiotherapy). Conclusions: LE for early-stage rectal cancer has lower 5-year OS and DFS than RE, with higher local recurrence rate. However, LE is associated with lower early postoperative mortality, morbidity and length of stay as compared to RE.

Indexed as

Early rectal cancerLocal excisionMetaanalysisRadical excisionT1-T2 rectal cancer

Identifiers

PMID38605826
PMCPMC11008054
OpenAlexW4391405570

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.