Rectal Cancer
Conditions
Keywords
Rectal cancer, taTME, Local recurrence
Brief summary
The purpose of this study was to compare the long-term oncology outcomes and specimen quality of taTME and laTME in the treatment of middle and low rectal cancer by a large sample cohort. At the same time, the local recurrence following a primary rectal cancer resection was analyzed to respond to the concerns about the event of the national suspension for TaTME due to the high local recurrence rate in Norway.
Detailed description
Laparoscopic surgery is considered to have better visualization for more accurate separation and further injury reduction than open surgery. However, the oncology outcomes are still controversial. Especially in the challenging patients who have narrow and deep pelvic, the disadvantage that it is difficult to obtain high-quality resected specimens during laparoscopic TME (laTME) surgery is considered to be magnified. It is considered transanal total mesorectal excision (taTME) is an alternative method to solve this old problem. However, as a new technology that has been around for only 10 years, the applicability of taTME worldwide needs to be further proved in long-term oncology. This prospective cohort study aimed to compare taTME surgery to laTME surgery for mid and low-rectal cancer on long-term oncology outcomes from a single, experienced Chinese center that was an early adopter of taTME.
Interventions
PROCEDUREtransanal total mesorectal excision
transanal TME
Sponsors
Sun Yat-sen University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. Age between 18 and 80 years old 2. Confirmed rectal adenocarcinoma cancer pathologically 3. Tumor location ≦ 12 cm from the anal margin 4. Willing and able to provide written informed consent for participation in this study
Exclusion criteria
1. Distant metastasis before surgery 2. More than one colorectal tumor at diagnosis 3. Familial adenomatous polyposis 4. Recurrent rectal cancer 5. Undergo transanal minimally invasive surgery 6. Undergo palliative treatment 7. Undergo emergency surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Overall survival rate | 5 years after the surgery |
| disease-free survival ratev | 5 years after the surgery |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Quality of the mesorectum specimen | 30 days after the surgery | The quality of the resected mesorectum was classified into three grades: (a) incomplete, (b) nearly complete, and (c) complete |
| Local recurrence rate | 3 years after the surgery | Local recurrence was defined as radiologic or histopathologic evidence of any recurrent disease deposit located in the pelvis in the prior area of dissection following a primary rectal cancer resection, with or without distal metastasis |
| DRM status | 30 days after the surgery | The DRM was regarded as positive if it was microscopically involved by or ≦1 mm from the tumor margins. |
| CRM status | 30 days after the surgery | The CRM was regarded as positive if the tumor distance or malignant lymph node to CRM was ≦1 mm. |
| Cancer special survival rate | 5 years after the surgery | Cancer special survival was defined as the time from the date of primary rectal cancer resection to the date of death caused by rectal cancer. |
Outcome results
None listed