Transanal local excision versus intersphincteric resection for low rectal cancer with stage ypT0-1ycN0 after neoadjuvant chemoradiotherapy: an inverse probability weighting analysis for oncological and functional outcomes.
Intersphincteric resection
Local excision
Locally advanced rectal cancer
Neoadjuvant therapy
Outcomes
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Dec 2023
Dec 2023
Historique:
received:
17
08
2023
accepted:
30
09
2023
medline:
27
11
2023
pubmed:
16
10
2023
entrez:
16
10
2023
Statut:
ppublish
Résumé
This study aimed to compare the efficacy of local excision (LE) and intersphincteric resection (ISR) in patients with locally advanced rectal cancer who achieved a significant or complete pathological response following neoadjuvant chemoradiotherapy. We performed a retrospective analysis of data from patients with stage ypT0-1ycN0 low rectal cancer after neoadjuvant chemoradiotherapy who underwent LE or ISR between June 2016 and June 2021. Baseline characteristics, short-term outcomes, long-term oncological outcomes, and functional outcomes, were compared between the two groups. To reduce the selection bias, inverse probability of treatment weighting (IPTW) was performed. This study included 106 patients (LE group: n = 51, ISR group: n = 55). There were significant differences in baseline characteristics between the two groups (P < 0.05). After IPTW, there were almost no significant differences in baseline data between the two groups. The LE group showed less postoperative complications and better function outcomes compared to the ISR group. The LE group had significantly lower rates of complications (13.7% vs. 36.4%, P = 0.014). There were no significant differences between the two groups in terms of long-term oncological outcomes. For patients with locally advanced low rectal cancer achieving significant or complete pathological response after neoadjuvant therapy, both LE and ISR present comparable oncological outcomes. Yet, LE seems to show more advantages in terms of postoperative complications and functional outcomes. These findings offer important insights for surgical decision-making, emphasizing the necessity to consider both oncological and functional outcomes in selecting the optimal surgical approach.
Identifiants
pubmed: 37843558
doi: 10.1007/s00432-023-05454-y
pii: 10.1007/s00432-023-05454-y
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
17383-17394Subventions
Organisme : Joint Funds for the innovation of Science and Technology, Fujian province
ID : 2017Y9038, 2019Y9101, 2020Y9071
Organisme : Fujian Provincial Health Technology Project
ID : 2020GGB022, 2020CXA025
Organisme : Natural Science Foundation of Fujian Province
ID : 2020J011030, 2022J01753
Organisme : Medical Science Research Foundation of Beijing Medical and Health Foundation
ID : B20062DS
Organisme : Bethune Charitable Foundation
ID : X-J-2018-004
Organisme : Construction Project of Fujian Province Minimally Invasive Medical Center
ID : Grant number: [2017]171
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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