ArticleAnnals of coloproctology2026
Surgical and oncologic outcomes of cT4b rectal cancer: a propensity score-matched comparison between a university center and regional hospitals.
Article in Annals of coloproctology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeSurgery for cT4b rectal cancer remains technically demanding, and outcomes may vary substantially across institutions. This study evaluated perioperative and oncologic outcomes of cT4b rectal cancer surgery performed at a university center compared with those at regional hospitals within a collaborative network.
methodsA total of 103 patients who underwent curative-intent surgery for cT4b rectal cancer between 2016 and 2024 were retrospectively reviewed. After 1:1 propensity score matching based on baseline characteristics and treatment factors, 54 patients were included in the analysis. Perioperative outcomes, pathological findings, and long-term oncologic outcomes were compared between the university hospital and affiliated regional institutions. Overall survival, relapse-free survival, and local control rate were additionally evaluated in patients with pathological stage II-III disease.
resultsPostoperative hospital stay was significantly shorter at the university center (18 days vs. 25 days, P=0.022). Local control was higher in the university hospital group (3-year local control rate: 95.2% vs. 71.5%, P=0.025). Among patients with pathological stage II-III disease, 3-year relapse-free survival was comparable between groups (51.8% vs. 49.0%, P=0.434), whereas local control demonstrated a favorable trend in the university hospital group (91.7% vs. 65.4%, P=0.063).
conclusionPerioperative safety in cT4b rectal cancer surgery was comparable across institutions; however, higher local control at the university center suggests that technically complex cases may benefit from selective centralization in specialized centers. These findings support a hybrid model in which regional collaboration ensures safety while advanced procedures are concentrated in specialized centers.
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