ArticleSurgical endoscopy2026
Which prognostic factors for recurrence after transanal endoscopic microsurgery for early rectal cancer?
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundTransanal endoscopic microsurgery (TEM) enables the local excision of rectal neoplasms with minimal invasiveness; however, the long-term oncologic safety for pTis and pT1 lesions, as well as the significance of traditional histopathological risk factors, remains controversial.
methodsA retrospective cohort of 170 consecutive patients undergoing en bloc, R0 full-thickness TEM for rectal pTis or pT1 adenocarcinoma between 1994 and 2025 at a single tertiary centre was analysed. Pathological review included Vienna classification, submucosal invasion (sm1 vs sm2-3), tumour grade (G1-2 vs G3), lymphovascular invasion (LVI), mucinous histotype, tumour budding, perineural invasion (PNI), and tumour diameter (> 3 cm). Patients with adverse features were recommended salvage radical surgery or adjuvant radiotherapy. Disease-free (DFS) and overall survival (OS) were estimated using Kaplan-Meier analysis and log-binomial regression.
resultsThe median age was 71 years (IQR, 62-77), and the median follow-up was 24 months (IQR, 24-53). Lesion distribution was Vienna 4.2 (n = 21), Vienna 4.4 (n = 21), pT1sm1 (n = 48), pT1sm2 (n = 40), and pT1sm3 (n = 40). All patients achieved R0 excision. No recurrences were observed in the Vienna 4.2/4.4 groups. For pT1 tumours, recurrence rates were 4.2% (sm1), 37.5% (sm2), and 20.0% (sm3). On multivariate analysis, submucosal invasion (sm2-3; HR 5.67, p = 0.021), high grade (G3; HR 3.58, p = 0.004), and LVI (HR 3.58, p = 0.003) were independent predictors of DFS. Other factors were not significant. In OS analysis, older age (> = 71 years) and tumour diameter > 3 cm were associated with poorer survival, whereas classical high-risk pathological factors (sm2-3, G3, LVI) were not.
conclusionTEM affords excellent long-term disease control for Vienna 4.2/4.4 lesions. In pT1 adenocarcinoma, only submucosal invasion beyond sm1, high grade, and LVI independently predict recurrence, underscoring the need for risk-adapted, multidisciplinary management.
Indexed as
Identifiers
What 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.