ArticleBJS open2024
Total mesorectal excision quality in rectal cancer surgery affects local recurrence rate but not distant recurrence and survival: population-based cohort study.
Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Navigating pelvic anatomy for exenteration: a clinical guide for radiologists.The British journal of radiology · 2026Review
- Short-term outcomes in robotic-assisted versus conventional laparoscopic surgery for rectal cancer: population-based study.BJS open · 2026Article
- Total mesorectal excision quality as a predictor of overall survival in rectal cancer: A retrospective cohort study.Turkish journal of surgery · 2026Article
- Association of skill and errors with outcomes in robotic rectal cancer surgery.Surgical endoscopy · 2026Article
- Learning curves and outcomes of robotic colorectal surgery: A single-surgeon experience within a structured dual-console training program.Journal of robotic surgery · 2026Article
- Robotic versus laparoscopic rectal cancer surgery during institutional transition: a 10-year sequential cohort study.Frontiers in oncology · 2026Article
- Surgeon- and procedure-specific variability in operative-time learning curves during parallel implementation of robotic colorectal surgery.Frontiers in oncology · 2026Article
- Effect of Total Mesorectal Excision (TME) quality on 3-year overall survival in low rectal cancer based on the LASRE trial.Scientific reports · 2025Article
- Robotic Versus Laparoscopic Versus Open Surgery for Rectal Cancer.Journal of clinical medicine · 2025Article
- Oncological and Functional Outcomes After Minimally Invasive Surgery for Mid and Low Rectal Adenocarcinoma: A Review.Cureus · 2025Review
- Total Mesorectal Excision with New Robotic Platforms: A Scoping Review.Journal of clinical medicine · 2024Article
- Prognosis and Risk Factors in Patients With Non-radical Circumferential Resection Margin After Rectal Cancer Surgery.In vivo (Athens, Greece)Article
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4 authors.
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Abstract
backgroundThe quality of the total mesorectal excision specimen in rectal cancer surgery is assessed with a three-tier grade (mesorectal, intramesorectal and muscularis propria). This study aimed to analyse the prognostic impact of the total mesorectal excision grade on survival, and to identify risk factors for intramesorectal and muscularis propria resection in a population-based setting.
methodsAll patients in the Swedish Colorectal Cancer Registry with rectal cancer stage I-III ≤ 10 cm from the anal verge, diagnosed 2015-2019, undergoing total mesorectal excision were analysed. Clinical, surgical and pathological data were retrieved and analysed for the following primary outcomes: local and distant recurrence and overall and relative survival; secondary outcomes were risk factors for total mesorectal excision grading (intramesorectal or muscularis propria resection). Of note, postoperative death < 30 days or recurrence within 90 days were exclusion criteria for survival and recurrence analysis. Recurrence-free patients with less than 3 years follow-up, and patients lacking data regarding recurrence, were also excluded from recurrence analyses.
resultsOverall, of 7979 patients treated during the study interval, 1499 patients were eligible for recurrence, 2441 patients for survival and 2476 patients for risk-factor analyses, of which 75% were graded mesorectal, 17% intramesorectal and 8% muscularis propria. Median follow-up for survival was 42 (1-77) months. The worst total mesorectal excision grading (muscularis propria resection) was an independent risk factor for local recurrence in multivariable analysis (HR 2.73, 95% c.i. 1.07 to 7.0, P = 0.036). Total mesorectal excision grade had no impact on distant recurrence or survival. Female sex, tumour level <5 cm, abdominoperineal resection, minimally invasive surgery (laparoscopic and robotic), high blood loss, long duration of surgery and intraoperative perforation were independent risk factors for worse total mesorectal excision grading (intramesorectal and/or muscularis propria resection) in multivariable analyses.
conclusionMuscularis propria resection increases the risk of local recurrence but does not seem to affect distant recurrence or survival.
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