Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan
Objective:. To investigate the oncological outcomes after transanal total mesorectal excision (TaTME) for rectal cancer and risk factors for local recurrence (LR). Background:. A high LR rate with a multifocal pattern early after TaTME has been reported in Norway and the Netherlands, causing controv...
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| Language: | English |
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Wolters Kluwer Health
2024-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000369 |
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| author | Takeru Matsuda, MD, PhD Ichiro Takemasa, MD, PhD Hideki Endo, MD, MPH Shinichiro Mori, MD, PhD Suguru Hasegawa, MD, PhD Koya Hida, MD, PhD Takuya Tokunaga, MD, PhD Keitaro Tanaka, MD, PhD Toshiki Mukai, MD, PhD Jun Watanabe, MD, PhD Junichiro Kawamura, MD, PhD Kei Kimura, MD, PhD Yoshihiro Kakeji, MD, PhD Masahiko Watanabe, MD, PhD Seiichiro Yamamoto, MD, PhD Takeshi Naitoh, MD, PhD Ta-Ta-Mi study group collaboratives in Japan Society of Laparoscopic Colorectal Surgery |
| author_facet | Takeru Matsuda, MD, PhD Ichiro Takemasa, MD, PhD Hideki Endo, MD, MPH Shinichiro Mori, MD, PhD Suguru Hasegawa, MD, PhD Koya Hida, MD, PhD Takuya Tokunaga, MD, PhD Keitaro Tanaka, MD, PhD Toshiki Mukai, MD, PhD Jun Watanabe, MD, PhD Junichiro Kawamura, MD, PhD Kei Kimura, MD, PhD Yoshihiro Kakeji, MD, PhD Masahiko Watanabe, MD, PhD Seiichiro Yamamoto, MD, PhD Takeshi Naitoh, MD, PhD Ta-Ta-Mi study group collaboratives in Japan Society of Laparoscopic Colorectal Surgery |
| author_sort | Takeru Matsuda, MD, PhD |
| collection | DOAJ |
| description | Objective:. To investigate the oncological outcomes after transanal total mesorectal excision (TaTME) for rectal cancer and risk factors for local recurrence (LR).
Background:. A high LR rate with a multifocal pattern early after TaTME has been reported in Norway and the Netherlands, causing controversy over the oncological safety of this technique.
Methods:. Twenty-six member institutions of the Japan Society of Laparoscopic Colorectal Surgery participated in this retrospective cohort study. A total of 706 patients with primary rectal cancer who underwent TaTME between January 2012 and December 2019 were included for analysis. The primary endpoint was the cumulative 3-year LR rate.
Results:. A total of 253 patients had clinical stage III disease (35.8%) and 91 (12.9%) had stage IV. Intersphincteric resection was performed in 318 patients (45.0%) and abdominoperineal resection in 193 (27.3%). There was 1 urethral injury (0.1%). A positive resection margin (R1) was seen in 42 patients (5.9%). Median follow-up was 3.42 years, and the 2- and 3-year cumulative LR rates were 4.95% (95% confidence interval: 3.50–6.75) and 6.82% (95% confidence interval: 5.08–8.89), respectively. A multifocal pattern was observed in 14 (25%) of 56 patients with LR. Tumor height from the anal verge, pathological T4 disease, pathological stage III/IV, positive perineural invasion, and R1 resection were significant risk factors for LR in multivariable analysis.
Conclusions:. In this selected cohort in which intersphincteric resection or abdominoperineal resection was performed in more than half of cases, oncological outcomes were acceptable during a median follow-up of more than 3 years. |
| format | Article |
| id | doaj-art-310fedbb966e4c58871fb7bd60b05753 |
| institution | Kabale University |
| issn | 2691-3593 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj-art-310fedbb966e4c58871fb7bd60b057532025-01-24T09:18:25ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-03-0151e36910.1097/AS9.0000000000000369202403000-00002Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in JapanTakeru Matsuda, MD, PhD0Ichiro Takemasa, MD, PhD1Hideki Endo, MD, MPH2Shinichiro Mori, MD, PhD3Suguru Hasegawa, MD, PhD4Koya Hida, MD, PhD5Takuya Tokunaga, MD, PhD6Keitaro Tanaka, MD, PhD7Toshiki Mukai, MD, PhD8Jun Watanabe, MD, PhD9Junichiro Kawamura, MD, PhD10Kei Kimura, MD, PhD11Yoshihiro Kakeji, MD, PhD12Masahiko Watanabe, MD, PhD13Seiichiro Yamamoto, MD, PhD14Takeshi Naitoh, MD, PhD15Ta-Ta-Mi study group collaboratives in Japan Society of Laparoscopic Colorectal Surgery* From the Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan† Department of Surgery, Surgical Oncology and Science Sapporo Medical University, Sapporo, Japan‡ Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan§ Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical Sciences, Kagoshima, Japan‖ Department of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan¶ Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan# Department of Surgery, Tokushima University, Tokushima, Japan** Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University, Takatsuki, Japan†† Gastroenterological Center, Department of Gastroenterological Surgery, the Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan‡‡ Department of Surgery, Gastroenterological Center Yokohama City University Medical Center, Yokohama, Japan§§ Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan‖‖ Division of Lower G.I., Department of Gastroenterological Surgery, Hyogo Medical University, Nishinomiya, Japan* From the Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan¶¶ Department of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan## Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Japan*** Department of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Sagamihara, Japan.Objective:. To investigate the oncological outcomes after transanal total mesorectal excision (TaTME) for rectal cancer and risk factors for local recurrence (LR). Background:. A high LR rate with a multifocal pattern early after TaTME has been reported in Norway and the Netherlands, causing controversy over the oncological safety of this technique. Methods:. Twenty-six member institutions of the Japan Society of Laparoscopic Colorectal Surgery participated in this retrospective cohort study. A total of 706 patients with primary rectal cancer who underwent TaTME between January 2012 and December 2019 were included for analysis. The primary endpoint was the cumulative 3-year LR rate. Results:. A total of 253 patients had clinical stage III disease (35.8%) and 91 (12.9%) had stage IV. Intersphincteric resection was performed in 318 patients (45.0%) and abdominoperineal resection in 193 (27.3%). There was 1 urethral injury (0.1%). A positive resection margin (R1) was seen in 42 patients (5.9%). Median follow-up was 3.42 years, and the 2- and 3-year cumulative LR rates were 4.95% (95% confidence interval: 3.50–6.75) and 6.82% (95% confidence interval: 5.08–8.89), respectively. A multifocal pattern was observed in 14 (25%) of 56 patients with LR. Tumor height from the anal verge, pathological T4 disease, pathological stage III/IV, positive perineural invasion, and R1 resection were significant risk factors for LR in multivariable analysis. Conclusions:. In this selected cohort in which intersphincteric resection or abdominoperineal resection was performed in more than half of cases, oncological outcomes were acceptable during a median follow-up of more than 3 years.http://journals.lww.com/10.1097/AS9.0000000000000369 |
| spellingShingle | Takeru Matsuda, MD, PhD Ichiro Takemasa, MD, PhD Hideki Endo, MD, MPH Shinichiro Mori, MD, PhD Suguru Hasegawa, MD, PhD Koya Hida, MD, PhD Takuya Tokunaga, MD, PhD Keitaro Tanaka, MD, PhD Toshiki Mukai, MD, PhD Jun Watanabe, MD, PhD Junichiro Kawamura, MD, PhD Kei Kimura, MD, PhD Yoshihiro Kakeji, MD, PhD Masahiko Watanabe, MD, PhD Seiichiro Yamamoto, MD, PhD Takeshi Naitoh, MD, PhD Ta-Ta-Mi study group collaboratives in Japan Society of Laparoscopic Colorectal Surgery Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan Annals of Surgery Open |
| title | Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan |
| title_full | Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan |
| title_fullStr | Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan |
| title_full_unstemmed | Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan |
| title_short | Local Recurrence of Rectal Cancer After Transanal Total Mesorectal Excision and Risk Factors: A Nationwide Multicenter Cohort Study in Japan |
| title_sort | local recurrence of rectal cancer after transanal total mesorectal excision and risk factors a nationwide multicenter cohort study in japan |
| url | http://journals.lww.com/10.1097/AS9.0000000000000369 |
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