SynthesisSurgical endoscopy2026
Is radical surgery always necessary in early rectal cancer? A systematic review of randomised trials.
Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTotal mesorectal excision (TME) remains the standard of care for operable rectal cancer but is associated with significant long-term morbidity. Local excision (LE) following neoadjuvant therapy offers a potential organ-preserving alternative in selected patients. This systematic review evaluates oncological, functional, and safety outcomes from randomised trials comparing LE and TME in early rectal cancer.
methodsA systematic review was conducted of randomised controlled trials comparing LE and TME in early-stage rectal adenocarcinoma. Trials were included if they enrolled predominantly cT2-T3N0 patients and compared either post-long course chemoradiotherapy (LCCRT) LE vs post-LCCRT TME, or neoadjuvant chemo(radiotherapy) + LE versus upfront TME. Primary outcomes were overall survival (OS) and disease-free survival (DFS); secondary outcomes included local/distant recurrence, functional outcomes, and health-related quality of life (HRQoL).
resultsFour trials (GRECCAR-2, Lezoche, TAUTEM, TREC; n = 514) met inclusion. Pathological complete response after LE ranged 26-44%, with 10-35% requiring completion TME. Within scenario-specific pools, there was no significant difference between LE and TME for OS or DFS, local or distant recurrence. LE was associated with lower major complications and better patient-reported outcomes.
conclusionIn selected patients who receive neoadjuvant therapy, local excision is associated with lower morbidity and favourable functional outcomes compared with TME. While scenario-specific estimates suggest comparable survival, heterogeneity in design and follow-up limits firm conclusions on oncologic equivalence. Within response-adapted pathways with predefined criteria for completion TME, local excision is a feasible organ-preserving option.
Indexed as
Identifiers
41286020What OpenQuestion holds
Registered trials
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.