Evidence map›Paper›PMID 41843298›Full record

ArticleAnnals of surgical oncology2026

Impact of Hospital Volume on Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision: A Nationwide Multicenter Cohort Study in Japan.

Naohito Beppu, Takeru Matsuda, Masataka Ikeda, Masataka Igeta, Ichiro Takemasa, Akiyoshi Kanazawa, Yukitoshi Todate, Yoshihiro Kakeji, Seiichiro Yamamoto, Takeshi Naitoh

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

10 authors.

Naohito BeppuDepartment of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Nishinomiya, Japan.
Takeru MatsudaDepartment of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. takerumatsuda@nifty.com.
Masataka IkedaDepartment of Gastroenterological Surgery, Division of Lower Gastrointestinal Surgery, Hyogo Medical University, Nishinomiya, Japan.
Masataka IgetaDepartment of Biostatistics, Centre for Clinical Research and Education, Hyogo Medical University, Nishinomiya, Hyogo, Japan.
Ichiro TakemasaDepartment of Gastroenterological Surgery, Osaka International Medical and Science Center, Osaka, Japan.
Akiyoshi KanazawaDepartment of Surgery, Shimane Prefectural Central Hospital, Izumo, Japan.
Yukitoshi TodateDepartment of Surgery, Southern TOHOKU Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Japan.
Yoshihiro KakejiDepartment of Surgery, Division of Gastrointestinal Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Seiichiro YamamotoDepartment of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan.
Takeshi NaitohDepartment of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConcerns have been raised regarding the risk of local recurrence (LR) following transanal total mesorectal excision (TaTME), particularly during the learning curve. This study aimed to evaluate the impact of hospital case volume on LR after TaTME in Japan. PATIENTS AND

methodsThis multicenter retrospective cohort study included 710 patients who underwent TaTME for rectal cancer at 25 institutions between 2014 and 2019. Hospitals were categorized as low volume (1-38 cases) or high volume (≥ 39 cases). The primary outcome was 5-year local recurrence rate (LRR). Multivariable Cox regression was performed to identify risk factors for LR.

resultsOf 710 patients, 277 were treated in low-volume hospitals and 433 in high-volume hospitals. The median follow-up was 46 months. Cumulative incidence of LR was significantly different (P = 0.048), and 5-year LRR was higher in the low-volume than in the high-volume groups (12.9% versus 6.8%). Multifocal LR was also more frequent in low-volume centers (4.1% versus 1.2%, P = 0.041). In multivariable analysis, treatment in low-volume hospitals was an independent predictor of LR (hazard ratio 2.15, 95% CI 1.25-3.69; P < 0.01). Subgroup analysis revealed increased LR in low-volume centers for patients undergoing anterior resection with the single stapling technique and for those with pT3/4 disease, nodal metastasis, or pathological lateral lymph node involvement.

conclusionsHospital case volume was independently associated with LR after TaTME. Although increased recurrence was observed in low-volume centers, particularly among certain subgroups, the volume effect likely reflects multifactorial institutional influences rather than technical aspects alone.

Indexed as

Neoplasm Recurrence, LocalProctectomyRectal NeoplasmsTransanal Endoscopic SurgeryAgedColorectal Surgical ProceduresFemaleFollow-Up StudiesHospitals, High-VolumeHospitals, Low-VolumeHumansJapanMaleMiddle AgedPrognosisRetrospective Studies

Identifiers

PMID41843298

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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.