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.

Systemic review and network meta‐analysis comparing minimal surgical techniques for rectal cancer: quality of total mesorectum excision, pathological, surgical, and oncological outcomes

2019 ◽  
Vol 119 (7) ◽  
pp. 987-998 ◽  
Author(s):  
Emanuele Rausa ◽  
Federica Bianco ◽  
Michael E. Kelly ◽  
Alberto Aiolfi ◽  
Fausto Petrelli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Systemic Review ◽  
Oncological Outcomes ◽  
Total Mesorectum Excision

295 Radiotherapy for Curative-intent Metastatic Rectal Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K R Y Nistala ◽  
J W Yeo ◽  
Z G W Ow ◽  
C H Ng ◽  
J H Law ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Meta Analysis ◽  
Complete Response ◽  
Cochrane Library ◽  
Neoadjuvant Radiotherapy ◽  
Curative Intent ◽  
Treatment Regimens ◽  
Oncological Outcomes ◽  
Logarithmic Method ◽  
Long Course

Abstract Introduction The role and optimal regimen of radiotherapy in curative-intent treatment of metastatic rectal cancer is unclear and hence a single arm meta-analysis was performed. Method Medline, Embase and Cochrane Library databases were searched up to 16 May 2020. A Meta-analysis of binomial data was performed using a Freeman-Tukey double arcsine transformation, and pooled estimates were used to construct risk ratios and confidence intervals via the Katz-logarithmic method. Additionally, comparative meta-analysis was performed with the Mantel Haenszel model. Results 18 studies were included. Rectal pathological complete response (pCR) was observed in 14% of tumours treated with radiotherapy (n = 57/388, CI 0.07 to 0.23). Comparative meta-analysis of cohort studies showed that treatment regimens including radiotherapy were associated with higher pT1 tumour and better oncological outcomes compared to regimens without radiotherapy. Katz-logarithmic method showed that neoadjuvant radiotherapy had a higher proportion of pN0 staging (RR = 1.81, 95% CI 1.06 to 3.09, p = 0.029) and better oncological outcomes compared to adjuvant radiotherapy, and that short course radiotherapy (SCRT) had a lower proportion of pT3 tumours (RR = 0.778, 95% CI 0.609 to 0.994, p = 0.044) and similar oncological outcomes compared to long course radiotherapy (LCRT). Conclusions This study supports the evidence that radiotherapy should be used in curative intent metastatic rectal cancer.

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

Long-term oncological outcomes in robotic versus laparoscopic approach for rectal cancer: A systematic review and meta-analysis

2020 ◽  
Vol 80 ◽  
pp. 225-230 ◽  
Author(s):  
Hua Qiu ◽  
Dongjun Yu ◽  
Shanping Ye ◽  
Renfeng Shan ◽  
Junhua Ai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Meta Analysis ◽  
Laparoscopic Approach ◽  
Oncological Outcomes

Intersphincteric Resection Versus Abdominoperineal Resection for Low Rectal Cancer: A Meta-Analysis

2020 ◽  
pp. 155335062091841
Author(s):  
Baifu Peng ◽  
Jiabao Lu ◽  
Zixin Wu ◽  
Guanwei Li ◽  
Fang Wei ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Abdominoperineal Resection ◽  
Postoperative Morbidity ◽  
Meta Analysis ◽  
Intersphincteric Resection ◽  
Low Rectal Cancer ◽  
Cochrane Library ◽  
Safe Alternative ◽  
Permanent Colostomy ◽  
Oncological Outcomes

Background. Abdominoperineal resection (APR) has been the standard surgery for ultra-low rectal cancer for a century. In recent years, intersphincteric resection (ISR) has been increasingly used to avoid the permanent colostomy. Up to now, there is no relevant meta-analysis comparing the clinical efficacy of ISR and APR. This meta-analysis aimed to compare the outcomes of these 2 procedures. Methods. A comprehensive search of online databases was performed on PubMed, EMBASE, and the Cochrane Library to obtain comparative studies of ISR and APR. Then the data from studies that met the inclusion criteria were extracted and analyzed. Results. A total of 12 studies covering 2438 patients were included. No significant differences were found between ISR and APR in gender, body mass index, distance from tumor to anal edge, operative time, and blood loss. In addition, hospital stay (weighted mean differences = −2.98 days; 95% confidence interval [CI] = −3.54 to −2.43; P < .00001) and postoperative morbidity (odds ratio [OR] = 0.76; 95% CI = 0.59 to 0.99; P = .04) were significantly lower in ISR group compared with APR group. However, patients who underwent ISR showed lower pathological T-stage (T3T4%, OR = 0.49; 95% CI = 0.28 to 0.86; P = .01) and lymph node metastasis rate (OR = 0.77; 95% CI = 0.59 to 1.01; P = .06) compared with those who underwent APR. Moreover, oncological outcomes were similar between the 2 groups. Conclusion. ISR may provide a safe alternative to APR, with shorter hospital stays, lower postoperative morbidity, and similar oncological outcomes. Well-designed randomized controlled trials are needed to confirm and update the findings of this analysis.

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