Disease-free Survival and Local Recurrence for Laparoscopic Resection Compared With Open Resection of Stage II to III Rectal Cancer

Fleshman, James W.; Branda, Megan E.; Sargent, Daniel J.; Boller, Anne Marie; George, Virgilio; Abbas, Maher A.; Peters, Walter R.; Maun, Dipen; Chang, George J.; Herline, Alan J.; Fichera, Alessandro; Mutch, Matthew G.; Wexner, Steven D.; Whiteford, Mark H.; Marks, John; Birnbaum, Elisa H.; Margolin, David A.; Larson, David W.; Marcello, Peter W.; Posner, Mitchell C.; Read, Thomas E.; Monson, J. R. T.; Wren, Sherry M.; Pisters, Peter W.T.; Nelson, Heidi

doi:10.1097/sla.0000000000003002

Cited by 312 publications

(231 citation statements)

References 12 publications

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“…They found that LapTME did not meet the criteria for noninferiority in a composite score of complete or near-complete TME, and negative circumferential and distal resection margins (13). It is important to note that Fleshman et al did not nd any difference in survival within two years after surgery (25). Still, the study was not designed as an equivalence trial for survival and recurrence, and the absence of numerical distinctions might not be indicative of any dissimilarity.…”

Section: Discussionmentioning

confidence: 99%

Three-year outcome after transanal versus laparoscopic total mesorectal excision in locally advanced rectal cancer: a multicenter comparative analysis

Lacy

Roodbeen²,

Ríos

et al. 2020

Preprint

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Background For patients with mid and distal rectal cancer, robust evidence on long-term outcome and causal treatment effects of transanal total mesorectal excision (TaTME) is lacking. This multicentre retrospective cohort study aimed to assess whether TaTME reduces locoregional recurrence rate compared to laparoscopic total mesorectal excision (LapTME). Methods Consecutive patients with rectal cancer within 12 centimetres from the anal verge and clinical stage II-III were selected from three institutional databases. Outcome after TaTME (Nov 2011 - Feb 2018) was compared to a historical cohort of patients treated with LapTME (Jan 2000 - Feb 2018) using the inverse probability of treatment weights method. The primary endpoint was three-year locoregional recurrence. Results A total of 710 patients were analysed, 344 in the TaTME group and 366 in the LapTME group. At three years, cumulative locoregional recurrence rates were 3.6% (95% CI, 1.1–6.1) in the TaTME group and 9.6% (95% CI, 6.5–12.7) in the LapTME group (HR = 0.4; 95% CI, 0.23–0.69; p = 0.001). Three-year cumulative disease-free survival rates were 74.3% (95% CI, 68.8–79.8) and 68.6% (95% CI, 63.7–73.5) (HR = 0.82; 95% CI, 0.65–1.02; p = 0.078) and three-year overall survival 87.2% (95% CI, 82.7–91.7) and 82.2% (95% CI, 78.0-86.2) (HR = 0.74; 95% CI, 0.53–1.03; p = 0.077), respectively. In patients who underwent sphincter preservation procedures, TaTME was associated with a significantly better disease-free survival (HR = 0.78; 95% CI, 0.62–0.98; p = 0.033). Conclusions These findings suggest that TaTME may improve locoregional recurrence and disease-free survival rates among patients with mid and distal locally advanced rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Three-year outcome after transanal versus laparoscopic total mesorectal excision in locally advanced rectal cancer: a multicenter comparative analysis

Lacy

Roodbeen²,

Ríos

et al. 2020

Preprint

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show abstract

“…As long as TME is performed, low local recurrence rates can be achieved in both open and minimally invasive approaches [16][17][18][19][20]. Oncologic long-term analysis found no statistically significant differences between laparotomy and laparoscopy [21,22]. Application of robotics-assisted low anterior rectal resection with TME results in oncologic outcomes comparable to those of other approaches [23].…”

Section: Radical Surgical Approachmentioning

confidence: 99%

Biology- and Location-Oriented Precision Treatment of Rectal Cancer: Present and Future

Fichtner‐Feigl

2020

Visc Med

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Background: The surgical approach in rectal cancer treatment has evolved in the last decades and a standardized surgical technique for tumor resection – total mesorectal excision – has been established. Summary: In a multidisciplinary effort with the use of total mesorectal excision in combination with adjuvant and neoadjuvant treatments to compliment surgery disease management can achieve excellent long-term local control and improved patient survival. Further improvements in imaging techniques and the ability to identify prognostic factors such as tumor regression, extramural venous invasion, and threatened margins have introduced the concept of decision-making based on preoperative staging information. Key Message: Therefore, in the modern era treatment algorithms are based on high-resolution imaging to plan neoadjuvant therapy and precision surgery followed by pathological and molecular analysis to stratify patients for the need of adjuvant chemotherapy. Despite excellent results with guideline structured treatment pathways, there is still a need to improve long-term results especially for individuals with locally advanced or metastatic tumors.

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“…In diesem Zusammenhang soll nicht unerwähnt bleiben, dass zwei kürzlich publizierte, randomisierte Studien aus Australien bzw. den USA (ALaCaRT, ACOSOG Z6051) [19,20,21] die Nichtunterlegenheit der laparoskopischen Resektion gegenüber der konventionellen Resektion in Bezug auf pathologische Parameter nicht nachweisen konnten.…”

Section: Epidemiologieunclassified

Minimalinvasive Techniken beim kolorektalen Karzinom

Rüth¹,

Heinrich²,

Thasler³

2018

Allgemein- und Viszeralchirurgie up2date

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Disease-free Survival and Local Recurrence for Laparoscopic Resection Compared With Open Resection of Stage II to III Rectal Cancer

Abstract: Laparoscopic assisted resection of rectal cancer was not found to be significantly different to OPEN resection of rectal cancer based on the outcomes of DFS and recurrence.

Cited by 312 publications

References 12 publications

Three-year outcome after transanal versus laparoscopic total mesorectal excision in locally advanced rectal cancer: a multicenter comparative analysis

Three-year outcome after transanal versus laparoscopic total mesorectal excision in locally advanced rectal cancer: a multicenter comparative analysis

Biology- and Location-Oriented Precision Treatment of Rectal Cancer: Present and Future

Minimalinvasive Techniken beim kolorektalen Karzinom

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