PDF(Pubmed)
Abstract：
UNASSIGNED: Radical excision (RE) for rectal cancer carries a higher risk of mortality and morbidity, while local excision (LE) could decrease these postoperative risks. However, the long-term benefit of LE is still debatable.
UNASSIGNED: To study the effectiveness of LE versus RE in T1 and T2 rectal cancer.
UNASSIGNED: A systematic review and meta-analysis was conducted using key databases like PubMed and ClinicalTrials.gov. Only cohort studies and randomized controlled trials were included. RevMan 5.4 tool was used for data analysis. Both clinical and statistical heterogeneity of the studies were assessed, and I2 >75% was considered as highly heterogeneous. The primary outcomes being measured were 5-year overall survival (OS) and 5-year disease free survival (DFS). A subgroup analysis of patients with T1-only was also conducted, without adjuvant chemo/radiotherapy.
UNASSIGNED: A total of 18 studies were included for final meta-analysis. Four were RCTs, while the other 15 were retrospective cohort studies. One included study had data from both RCT and non-RCT study groups. Nine studies were multicentered or national studies while nine were unicentral.There was no difference in risk ratio (RR) between OS: RR 0.95, 95% Confidence Interval (CI) [0.91, 0.99] and DFS: RR 0.93, 95% CI [0.87, 1.01]. There were lower hazards ratios in OS: RR 1.41, 95% CI [1.14, 1.74] and DFS: RR 1.95, 95% CI [1.36, 2.78] with radical, as compared to LE. Lower recurrence rate was associated with RE. Random effect model was used due to clinical heterogeneity between studies (different surgical procedures, tumor staging, adjuvant chemo or radiotherapy).
UNASSIGNED: LE for early-stage rectal cancer has lower 5-year OS and DFS than RE, with higher local recurrence rate. However, LE is associated with lower early postoperative mortality, morbidity and length of stay as compared to RE.
UNASSIGNED: To study the effectiveness of LE versus RE in T1 and T2 rectal cancer.
UNASSIGNED: A systematic review and meta-analysis was conducted using key databases like PubMed and ClinicalTrials.gov. Only cohort studies and randomized controlled trials were included. RevMan 5.4 tool was used for data analysis. Both clinical and statistical heterogeneity of the studies were assessed, and I2 >75% was considered as highly heterogeneous. The primary outcomes being measured were 5-year overall survival (OS) and 5-year disease free survival (DFS). A subgroup analysis of patients with T1-only was also conducted, without adjuvant chemo/radiotherapy.
UNASSIGNED: A total of 18 studies were included for final meta-analysis. Four were RCTs, while the other 15 were retrospective cohort studies. One included study had data from both RCT and non-RCT study groups. Nine studies were multicentered or national studies while nine were unicentral.There was no difference in risk ratio (RR) between OS: RR 0.95, 95% Confidence Interval (CI) [0.91, 0.99] and DFS: RR 0.93, 95% CI [0.87, 1.01]. There were lower hazards ratios in OS: RR 1.41, 95% CI [1.14, 1.74] and DFS: RR 1.95, 95% CI [1.36, 2.78] with radical, as compared to LE. Lower recurrence rate was associated with RE. Random effect model was used due to clinical heterogeneity between studies (different surgical procedures, tumor staging, adjuvant chemo or radiotherapy).
UNASSIGNED: LE for early-stage rectal cancer has lower 5-year OS and DFS than RE, with higher local recurrence rate. However, LE is associated with lower early postoperative mortality, morbidity and length of stay as compared to RE.
摘要：
■直肠癌根治术（RE）具有较高的死亡率和发病率风险，而局部切除术（LE）可以降低这些术后风险。然而,LE的长期利益仍有争议。
■研究LE与RE在T1和T2直肠癌中的有效性。
■使用PubMed和ClinicalTrials.gov等关键数据库进行了系统评价和荟萃分析。仅纳入队列研究和随机对照试验。使用RevMan5.4工具进行数据分析。评估了研究的临床和统计异质性，I2>75%被认为是高度异质的。测量的主要结果是5年总生存期（OS）和5年无病生存期（DFS）。还对仅T1患者进行了亚组分析，没有辅助化疗/放疗。
■共有18项研究纳入最终荟萃分析。四个是RCT,其他15项为回顾性队列研究.一项纳入研究的数据来自RCT和非RCT研究组。9项研究是多中心或国家研究，而9项是单中心研究。OS:RR0.95,95%置信区间(CI)[0.91,0.99]和DFS:RR0.93,95%CI[0.87,1.01]之间的风险比(RR)没有差异。OS:RR1.41,95%CI[1.14,1.74]和DFS:RR1.95,95%CI[1.36,2.78]的危险比较低,与LE相比。较低的复发率与RE相关。由于研究之间的临床异质性，使用随机效应模型(不同的外科手术，肿瘤分期,辅助化疗或放疗)。
■用于早期直肠癌的LE的5年OS和DFS比RE低，局部复发率较高。然而,LE与较低的术后早期死亡率相关，与RE相比，发病率和住院时间。
■研究LE与RE在T1和T2直肠癌中的有效性。
■使用PubMed和ClinicalTrials.gov等关键数据库进行了系统评价和荟萃分析。仅纳入队列研究和随机对照试验。使用RevMan5.4工具进行数据分析。评估了研究的临床和统计异质性，I2>75%被认为是高度异质的。测量的主要结果是5年总生存期（OS）和5年无病生存期（DFS）。还对仅T1患者进行了亚组分析，没有辅助化疗/放疗。
■共有18项研究纳入最终荟萃分析。四个是RCT,其他15项为回顾性队列研究.一项纳入研究的数据来自RCT和非RCT研究组。9项研究是多中心或国家研究，而9项是单中心研究。OS:RR0.95,95%置信区间(CI)[0.91,0.99]和DFS:RR0.93,95%CI[0.87,1.01]之间的风险比(RR)没有差异。OS:RR1.41,95%CI[1.14,1.74]和DFS:RR1.95,95%CI[1.36,2.78]的危险比较低,与LE相比。较低的复发率与RE相关。由于研究之间的临床异质性，使用随机效应模型(不同的外科手术，肿瘤分期,辅助化疗或放疗)。
■用于早期直肠癌的LE的5年OS和DFS比RE低，局部复发率较高。然而,LE与较低的术后早期死亡率相关，与RE相比，发病率和住院时间。
