META-ANALYSIS OF THE RECURRENCE AND SURVIVAL RATE REGARDING THE DISTAL RESECTION MARGIN LENGTH IN RECTAL CANCER SURGERY
Received 2021-01-08; Accepted 2021-10-21; Published 2022-07-01
Background: The optimal distal resection margin (DRM) in rectal cancer surgery required to achieve an adequate oncological outcome remains controversial. The changing trends of the study results showed favorable outcomes of patients receiving as minimal a margin as possible. Therefore, this study aimed to perform a meta-analysis of the recurrence and survival rate regarding the DRM in rectal cancer surgery.
Methods: The study design followed the PRISMA guidelines. The journal was traced and then analyzed with parameters of local recurrence, distant recurrence, disease-free survival, and overall survival rate. Data was analyzed by Review Manager 5.3.
Results: There was a total of 48 studies included in this meta-analysis. There was no difference in recurrence rate by taking 1 cm as the cut-off point for DRM. However, limiting the studies to those measured DRM in a fresh specimen, the local recurrence rate was significantly higher in the group with DRM less than 1 cm to more than 1 cm (OR 1.92; 95%CI 1.21-3.06; p=0.006; I2 35%). The recurrence rate was significantly higher in the group with DRM less than 5 mm than the group with DRM more than 5 mm (OR 1.52; 95%CI 1.05-2.29; p=0.03; I2 34%).
Conclusion: This meta-analysis showed that taking 5 mm as a cut-off point was optimal to control the local recurrence rate in rectal cancer. The difference between distant recurrence and survival rate could not be determined due to a lack of data from previous studies.
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