Meta-analysis of oncological outcomes after local excision of pT1-2 rectal cancer requiring adjuvant (chemo)radiotherapy or completion surgery

2016 ◽  
Vol 103 (9) ◽  
pp. 1105-1116 ◽  
Author(s):  
W. A. A. Borstlap ◽  
T. J. Coeymans ◽  
P. J. Tanis ◽  
C. A. M. Marijnen ◽  
C. Cunningham ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Meta Analysis ◽  
Oncological Outcomes ◽  
Completion Surgery

scholarly journals Local excision followed by early radical surgery in rectal cancer: long-term outcome

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Theodor Junginger ◽  
Ursula Goenner ◽  
Mirjam Hitzler ◽  
Tong T. Trinh ◽  
Achim Heintz ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Excision ◽  
Radical Surgery ◽  
Rectal Wall ◽  
Residual Tumor ◽  
Clinical Staging ◽  
Oncological Outcomes ◽  
Primary Surgery ◽  
Completion Surgery

Abstract Background In rectal cancers, radical surgery should follow local excisions, in cases of unexpected, unfavorable tumor characteristics. The oncological results of this completion surgery are inconsistent. This retrospective cohort study assessed the clinical and long-term oncological outcomes of patients that underwent completion surgery to clarify whether a local excision compromised the results of radical surgery. Methods Forty-six patients were included, and the reasons for completion surgery, intraoperative complications, residual tumors, local recurrences (LRs), distant metastases, and cancer-specific survival (CSS) were assessed. The results were compared to 583 patients that underwent primary surgery without adjuvant therapy, treated with a curative intention during the same time period. Results The median follow-up was 14.6 years. The reasons for undergoing completion surgery were positive resection margins (24%), high-risk cancer (30%), or both (46%). Intraoperative perforations occurred in 10/46 (22%) cases. Residual tumor in the rectal wall or lymph node involvement occurred in 12/46 (26%) cases. The risk of intraoperative perforation and residual tumor increased with the pT category. Intraoperative perforations did not increase postoperative complications, but they increased the risk of LRs in cases of intramural residual tumors (p = 0.003). LRs occurred in 2.6% of pT1/2 and 29% of pT3 tumors. Both the 5- and 10-year CSS rates were 88.8% (95% CI 80.0–98.6). Moreover, the LRs of patients with pT1/2 cancers were lower in patients with completion surgery than in patients with primary surgery. Conclusions Rectal wall perforations at the local excision site and residual cancer were the main risks for poor oncological outcomes associated with completion surgery. Local excisions followed by early radical surgery did not appear to compromise outcomes compared to patients with primary surgery for pT1/2 rectal cancer. Improvements in clinical staging should allow more appropriate selection of patients that are eligible for a local excision of rectal cancer.

AB151. 85. Comparative oncological outcomes of upper third rectal cancer: a meta-analysis

2018 ◽  
Vol 2 ◽  
pp. AB151-AB151
Author(s):  
Michael Flanagan ◽  
Cillian Clancy ◽  
Deborah McNamara ◽  
John P. Burke
Keyword(s):  
Rectal Cancer ◽  
Meta Analysis ◽  
Oncological Outcomes ◽  
Upper Third

scholarly journals Laparoscopic versus Open Surgery in Lateral Lymph Node Dissection for Advanced Rectal Cancer: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Manzhao Ouyang ◽  
Tianyou Liao ◽  
Yan Lu ◽  
Leilei Deng ◽  
Zhentao Luo ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Open Surgery ◽  
Meta Analysis ◽  
Advanced Rectal Cancer ◽  
R0 Resection ◽  
Resection Rate ◽  
Lateral Lymph Node ◽  
Oncological Outcomes ◽  
Conventional Open Surgery

Aim. To compare the clinical efficacies between laparoscopic and conventional open surgery in lateral lymph node dissection (LLND) for advanced rectal cancer. Methods. We comprehensively searched PubMed, Embase, Cochrane Library, CNKI, and Wanfang Data and performed a cumulative meta-analysis. According to inclusion criteria and exclusion criteria, all eligible randomized controlled trials (RCTs) or retrospective or prospective comparative studies assessing the two techniques were included, and then a meta-analysis was performed by using RevMan 5.3 software to assess the difference in clinical and oncological outcomes between the two treatment approaches. Results. Eight studies involving a total of 892 patients were finally selected, with 394 cases in the laparoscopic surgery group and 498 cases in the traditional open surgery group. Compared with the traditional open group, the laparoscopic group had a longer operative time (WMD=81.56, 95% CI (2.09, 142.03), P=0.008), but less intraoperative blood loss (WMD=−452.18, 95% CI (-652.23, -252.13), P<0.00001), shorter postoperative hospital stay (WMD=−5.30, 95% CI (-8.42, -2.18), P=0.0009), and higher R0 resection rate (OR=2.17, 95% CI (1.14, 4.15), P=0.02). There was no significant difference in the incidence of surgical complications between the two groups (OR=0.52, 95% CI (0.26, 1.07), P=0.08). Lateral lymph node harvest, lateral lymph node metastasis, local recurrence, 3-year overall survival, and 3-year disease-free survival did not differ significantly between the two approaches (P>0.05). Conclusion. Laparoscopic LLND has a similar efficacy in oncological outcomes and postoperative complications to the conventional open surgery, with the advantages of reduced intraoperative blood loss, shorter postoperative hospital stay, and higher R0 resection rate, and tumor radical cure is similar to traditional open surgery. Laparoscopic LLND is a safe and feasible surgical approach, and it may be used as a standard procedure in LLND for advanced rectal cancer.

Functional and Oncological Outcomes After Transanal Local Excision for Rectal Cancer. A Prospective Study

2011 ◽  
Vol 37 (12) ◽  
pp. S4
Author(s):  
G. Luglio ◽  
V. Celentano ◽  
R. Tarquini ◽  
V. Sollazzo ◽  
M.C. Giglio ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prospective Study ◽  
Local Excision ◽  
Transanal Local Excision ◽  
Oncological Outcomes ◽  
A Prospective Study
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