Evidence map›Paper›PMID 39948076›Full record

Trial reportScientific reports2025

Prognosis and quality of life in patients with locally advanced rectal cancer after abdominoperineal resection in the CAO/ARO/AIO-04 randomized phase 3 trial.

Jochen Gaedcke, Malte Sahrhage, Marcel Ebeling, Azadeh Azizian, Felix Rühlmann, Markus Bernhardt, Marian Grade, Wolf Otto Bechstein, Christoph-Thomas Germer, Robert Grützmann and 9 more

Abstract readClinical Trial, Phase IIIRandomized Controlled Trial
In one paragraph

Trial report in Scientific reports, 2025. 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
–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.

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.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Article
  6. Surgical treatment of colorectal cancer: A multidimensional review.World journal of gastrointestinal surgery · 2025
    Review
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

19 authors.

Jochen GaedckeDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany. j.gaedcke@gmail.com.
Malte SahrhageDepartment of Medical Bioinformatics, University Medical Centre Göttingen, Göttingen, Germany.
Marcel EbelingDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Azadeh AzizianDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Felix RühlmannDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Markus BernhardtDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Marian GradeDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
Wolf Otto BechsteinDepartment of General and Visceral Surgery, University of Frankfurt, Frankfurt, Germany.
Christoph-Thomas GermerDepartment of General and Visceral Surgery, University of Würzburg, Würzburg, Germany.
Robert GrützmannDepartment of Surgery, University Hospital Erlangen, Erlangen, Germany.
Pompiliu PisoDepartment of General and Visceral Surgery, Krankenhaus Barmherzige Brüder Regensburg, Regensburg, Germany.
Ralf-Dieter HofheinzDepartment of Medical Oncology, University Medical Centre Mannheim, Mannheim, Germany.
Ludger StaibDepartment of Surgery, Klinikum Esslingen, Esslingen, Germany.
Tim BeißbarthDepartment of Medical Bioinformatics, University Medical Centre Göttingen, Göttingen, Germany.
Rebekka KosmalaDepartment of Radiation Oncology, University Hospital Würzburg, Würzburg, Germany.
Emmanouil FokasDepartment of Radiotherapy, University of Cologne, Cologne, Germany.
Claus RödelDepartment of Radiotherapy, University of Frankfurt, Frankfurt, Germany.
Michael GhadimiDepartment of General, Visceral, and Paediatric Surgery, University Medical Centre Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
German Rectal Cancer Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Low anterior resection (LAR) and abdominoperineal resection (APR) are the two main surgical procedures after preoperative chemoradiotherapy (CRT) for locally advanced rectal cancer. APR is associated with poorer prognosis; however existing data do not consider intensified CRT (5-Fluorouracil (5-FU)/Oxaliplatin + radiation) protocols. Clinicopathological data of patients treated with APR and LAR from the CAO/ARO/AIO-04 trial were analysed in terms of prognostic parameters and quality of life (QoL). Based on higher response rate after intensified CRT, subgroup analyses were performed. Data from n = 1173 patients were assessed. APR after preoperative CRT was associated with a significantly worse overall survival (p = 0.0056), disease-free survival (p < 0.0001) and local recurrence rate (p = 0.0047). Clinicopathological data including clinical T stage (p < 0.000001), grading (p = 0.0038), postoperative lymph node (LN) positivity (p = 0.013), and number of positive LN (p = 0.0049) significantly differed between procedures and showed higher values in APR patients. The quality of total mesorectal excision (TME) was significantly better (p < 0.0001) and complete resection rates were higher (p = 0.0022) in LAR compared to APR patients. Subgroup analyses showed worse LR rates in APR patients after standard CRT (5-FU mono and radiation) but not after intensified CRT. After 3 years, role functioning (p = 0.019) and physical functioning (p = 0.001) had a slightly poorer outcome in APR patients. The poorer prognosis of patients undergoing APR for locally advanced rectal cancer may be explained by clinicopathological characteristics. Intensified CRT may compensate for the higher risk of LR after APR in patients with worse TME quality. QoL in APR patients was comparable to LAR patients.

Indexed as

ProctectomyQuality of LifeRectal NeoplasmsAdultAgedChemoradiotherapyFemaleFluorouracilHumansMaleMiddle AgedNeoplasm Recurrence, LocalPrognosisFluorouracil

Identifiers

PMID39948076
PMCPMC11825916

What OpenQuestion holds

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Registered trials

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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.