Randomized trial compares upfront total mesorectal excision with neoadjuvant therapy in low-risk cT3 rectal cancer, suggesting similar outcomes.
Key Points
This analysis aims to compare the efficacy of upfront total mesorectal excision against neoadjuvant therapy in low-risk cT3 rectal cancer patients as determined by MRI.
Systematic search of PubMed, Scopus, and Cochrane Central through June 2025.
Five studies including 1447 patients were analyzed using random-effects models to calculate pooled odds ratios, mean differences, and hazard ratios.
A Bayesian random-effects meta-analysis provided insights into potential equivalence between both treatment strategies.
Upfront surgery resulted in shorter operative time (mean difference −25.7 min; 95% CI −38.6 to −12.7).
More lymph nodes were retrieved during upfront surgery (mean difference 6.6; 95% CI 6.0-7.3).
No significant differences were found in perioperative complications, including anastomotic leaks or reoperations.