Evidence map›Paper›PMID 40149327›Full record

ArticleCancers2025

Analysis of Local Recurrence After Robotic-Assisted Total Mesorectal Excision (ALRITE): An International, Multicentre, Retrospective Cohort.

Ritch T J Geitenbeek, Rauand Duhoky, Thijs A Burghgraef, Guglielmo Niccolò Piozzi, Shamsul Masum, Adrian A Hopgood, Quentin Denost, Ellen van Eetvelde, Paolo Bianchi, Philippe Rouanet and 6 more

Abstract read
In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Review
  2. Observational
  3. 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

16 authors.

Ritch T J GeitenbeekDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.ORCID 0000-0002-4707-0319
Rauand DuhokyDepartment of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, UK.ORCID 0000-0003-3118-0641
Thijs A BurghgraefDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
Guglielmo Niccolò PiozziDepartment of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, UK.ORCID 0000-0001-6667-9202
Shamsul MasumSchool of Electrical and Mechanical Engineering, University of Portsmouth, Portsmouth PO1 3HE, UK.ORCID 0000-0001-8489-9356
Adrian A HopgoodFaculty of Technology, University of Portsmouth, Portsmouth PO1 3HE, UK.ORCID 0000-0002-7183-5799
Quentin DenostBordeaux Colorectal Institute, Clinique Tivoli, 33300 Bordeaux, France.
Ellen van EetveldeDepartment of Surgery, Universitair Ziekenhuis Brussel, 1090 Jette, Belgium.
Paolo BianchiGeneral Surgery Unit, Department of Health Sciences (DISS), University of Milan San Paolo Hospital, 20142 Milan, Italy.
Philippe RouanetSurgery Department, Montpellier Cancer Institute (ICM), Université Montpellier, 34090 Montpellier, France.ORCID 0000-0003-0415-3269
Roel HompesDepartment of Surgery, University Medical Center Amsterdam, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Marcos Gómez RuizDepartment of Surgery, Marqués de Valdecilla University Hospital, 39008 Santander, Spain.
Jim BriggsCentre for Healthcare Modelling and Informatics, University of Portsmouth, Portsmouth PO1 3HE, UK.ORCID 0000-0003-1559-4879
Jim S KhanDepartment of Colorectal Surgery, Portsmouth Hospitals University NHS Trust, Portsmouth PO6 3LY, UK.ORCID 0000-0002-3031-4495
Esther C J ConstenDepartment of Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.
On Behalf Of The Alrite Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesRectal cancer is a major global health issue with high morbidity and mortality rates. Local recurrence (LR) significantly impacts patient outcomes, decreasing survival rates and often necessitating extensive secondary treatments. While robot-assisted total mesorectal excision (R-TME) is becoming a preferred method for rectal cancer surgery due to its improved precision and visualisation, long-term data on LR and predictors of recurrence remain limited. This study aims to determine the 3-year LR rate following R-TME and to identify predictors of recurrence to enhance patient selection and the personalisation of treatment.

methodsThis retrospective international multicentre cohort study included 1039 consecutive rectal cancer patients who underwent R-TME between 2013 and 2020, with a minimum of 3 years of follow-up. Data from tertiary colorectal centres in the United Kingdom, the Netherlands, Spain, France, Italy, and Belgium were analysed. Potential predictors of LR were identified using backward elimination, and four machine learning models were evaluated for predicting LR.

resultsThe 3-year LR rate was 3.8%. Significant predictors of LR included advanced clinical M-staging, length of the hospital stay, postoperative ileus, postoperative complications, pathological N-staging, the completeness of resection, and the resection margin distance. The eXtreme Gradient Boosting model performed best for LR prediction, with a final accuracy of 77.1% and an AUC of 0.76.

conclusionsR-TME in high-volume centres achieves low 3-year LR rates, suggesting that robot-assisted surgery offers oncological safety and advantages in rectal cancer management. This study underscores the importance of surgical precision, patient selection, and standardised perioperative care, supporting further investment in robotic training to improve long-term patient outcomes.

Indexed as

artificial intelligenceprediction modelsrectal cancerrobot-assisted surgerytotal mesorectal excision

Identifiers

PMID40149327
PMCPMC11940555

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.