ArticleBMJ open2026
Surgical safety of preoperative or perioperative immune checkpoint inhibitors in colorectal cancer surgery: protocol for a systematic review and meta-analysis focusing on anastomotic leakage.
Article in BMJ open, 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
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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.
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Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionImmune checkpoint inhibitors (ICIs) are increasingly used before colorectal cancer surgery, particularly for mismatch repair-deficient or microsatellite instability-high tumours. Their surgery-specific safety, especially the risk of anastomotic leakage (AL), remains uncertain. We aim to synthesise AL and other postoperative outcomes after preoperative or perioperative ICI therapy. METHODS AND ANALYSIS: We will search PubMed/MEDLINE, Embase, Web of Science, Scopus, CENTRAL, ClinicalTrials.gov, CNKI and the WHO International Clinical Trials Registry Platform from inception to July 2026 without language restrictions. We will include randomised and non-randomised comparative studies, cohort and case-control studies and single-arm studies reporting postoperative outcomes after preoperative or perioperative ICI therapy; case reports and case series with fewer than five surgically treated patients will be excluded. The primary outcome is AL among patients who underwent bowel resection with a constructed intestinal anastomosis. Two reviewers will independently screen records, extract data and assess risk of bias using design-appropriate validated tools. Comparative and non-comparative studies will be analysed separately: risk ratios from comparative studies will be pooled in random-effects models, and single-arm AL rates will be pooled as proportions using a binomial-logit generalised linear mixed model. Heterogeneity, prespecified subgroup analyses, sensitivity analyses and the certainty of the evidence (Grading of Recommendations Assessment, Development and Evaluation) will be reported. ETHICS AND DISSEMINATION: Ethics approval is not required because only published aggregate data will be used. Results will be submitted to a peer-reviewed journal and presented at scientific meetings. Extraction materials, analytical code and the derived dataset will be shared in an open repository with the completed review. PROSPERO REGISTRATION NUMBER: CRD420261426134.
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