Surgical Outcomes of Rectal Resection: Our 10 Years Experience

Oldani, Alberto; Cesana, Giovanni; Uccelli, Matteo; Ciccarese, Francesca; Giorgi, Riccardo; Carli, Stefano Maria De; Villa, Roberta; Olmi, Stefano

doi:10.1089/lap.2018.0731

Cited by 2 publications

(2 citation statements)

References 21 publications

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“…Radical surgery of mid-low rectal cancer can bring great trauma to patients, and some patients require removal of their anus [ 27 ], which could result in a serious impact on patients’ physical and mental health [ 28 ]. In 2004, Habr-Gama first reported the wait and see (non-surgical) treatment strategy for low rectal cancer patients who obtained cCR after chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of wait and see strategy versus radical surgery and local excision for rectal cancer with cCR response after neoadjuvant chemoradiotherapy: a meta-analysis

Zhao

Deng

et al. 2020

World J Surg Onc

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Background: Neoadjuvant therapy can shrink tumors, increase anus preservation rate, and protect anal function. Radical surgery need cut off the diseased bowel, clean up the lymph nodes, and then restore bowel function. It could bring traumatic effect and poor postoperative quality of life to the patient. Local resection requires removal of the diseased bowel with circular negative margin. The surgical trauma is small, and the postoperative quality of life is good. In this meta-analysis, we aimed to evaluate the efficacy and safety between wait and see strategy (WS), radical surgery (RS), and local excision (LE) of rectal cancer patients with clinical complete response (cCR) response after neoadjuvant chemoradiotherapy. Methods: We searched PubMed, Cochrane Library, CNKI (China National Knowledge Infrastructure), and Wanfang databases to compare wait and see strategy with radical surgery and local excision for rectal cancer with cCR response after neoadjuvant chemoradiotherapy up to March 2020. We collected the data of local recurrence, distant metastasis, cancer-related death, overall survival, and disease-free survival and used RevMan 5.0 to carry out the meta-analysis. Continuous data were evaluated by the standardized mean differences (SMD) with 95% confidence intervals (95% CIs), and dichotomous data were evaluated by relative risks (ORs or RRs) with 95% CIs. We aimed to compare the advantages and disadvantages of the three groups. Results: Eleven English studies with 1131 patients were included. There were 412 patients in WS group, 678 patients in RS group, and 41 patients in LE group. WS group had a higher local recurrence rate than RS group (OR 7.32, 95% CI 3.58 to 14.95, P < 0.001). There was no significant difference in the other data between the three groups.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of wait and see strategy versus radical surgery and local excision for rectal cancer with cCR response after neoadjuvant chemoradiotherapy: a meta-analysis

Zhao

Deng

et al. 2020

World J Surg Onc

View full text Add to dashboard Cite

show abstract

“…Radical surgery of mid-low rectal cancer could bring great trauma to patients and some patients could need to remove their anus. It had a serious impact on patients' physical and mental health [24]. In 2004, Habr-Gama first reported wait and see(non-surgical) treatment strategy for low rectal cancer patients who obtained cCR after chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of wait and see strategy versus surgery for rectal cancer with cCR/near-cCR response after neoadjuvant chemoradiotherapy: a meta-analysis

zhao

Deng

et al. 2020

Preprint

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Background: To evaluate the efficacy and safety between wait and see strategy (WS) and surgery of rectal cancer patients with cCR/near-cCR response after neoadjuvant chemoradiotherapy.Methods: We searched PubMed, Cochrane Library, CNKI(China National Knowledge Infrastructure) and Wanfang databases to compare wait and see strategy with surgery for rectal cancer with cCR/near-cCR response after neoadjuvant chemoradiotherapy up to January 2020. We collected the data of local recurrence, distant metastasis, cancer related death, overall survival and diseasr-free survival and compared the advantages and disadvantages of the two groups.Results: 14 English studies with 3932 patients were included. There were 700 patients in WS group and 3232 patients in surgical group. WS group had higher local recurrence rate than surgery group(OR:3.55, 95% CI :2.35 to 5.36, P<0.001). WS group had better 2-year DFS(OR:0.74, 95% CI :0.56 to 0.96, P=0.03) and 2-year OS (OR:0.38, 95% CI :0.28 to 0.52, P<0.001) than surgery group. Subgroup analysis of WS group and radical surgery group also obtained the similar results. Eastern studies also supported the conclusion. There was no significant difference of other data between the two groups.Conslusion: Compared with surgery group, WS group would increase the risk of local recurrence rate, but WS group had better 2-year DFS and OS than surgery group. However, WS group did not increase the possibility of distant metastasis and cancer related death of the patients.

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Surgical Outcomes of Rectal Resection: Our 10 Years Experience

Cited by 2 publications

References 21 publications

Efficacy and safety of wait and see strategy versus radical surgery and local excision for rectal cancer with cCR response after neoadjuvant chemoradiotherapy: a meta-analysis

Efficacy and safety of wait and see strategy versus radical surgery and local excision for rectal cancer with cCR response after neoadjuvant chemoradiotherapy: a meta-analysis

Efficacy and safety of wait and see strategy versus surgery for rectal cancer with cCR/near-cCR response after neoadjuvant chemoradiotherapy: a meta-analysis

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