A Meta-Analysis Of The Safety And Effectiveness Of Local Resection For Early Rectal Cancer

Objective:Radical surgery procedures in patients with rectal cancinoma were associated with more complications.More surgeons were interested in the local surgery procedures for early rectal cancer in recent decades. However,the safety and effectiveness of LR in patients with early rectal cancinoma remain unclear. The purposes of our meta-analysis was to evaluate the differences in complications、local recurrences and overall survivals associated with LR and RR for early rectal cancinoma.Methed:Pubmed, EMBASE, MEDLINE, Cochrane Library, SinoMed CBM, CNKI, Wanfang data and VIP were retrieved. RCTs which comparing the effect of LR and RR for treating early rectal carcinoma were included. Revman 5.3 and STATA 12 software were used to complete the statistics analyses.Results:7 RGTs, including 601 patients of early rectal cancer(local resection group had 304 cases and radical resection group had 297 cases),were included. Local resection group comparing with the radical resection group, had significantly less complication (Relative Risk (RR) =0.35,95% Confidence Interval (CI)=[0.16,0.76], P=0.008), shorter operating time and postoperative hospitalization,and less blood loss, but had significantly more local recurrences (RR=3.69,95%CI[1.67,8.15], P=0.001) and overall recurrences (RR=2.24,95%CI[1.30,3.88], P=0.004).However, no significantly differences in overall survival (Hazard ratio(HR)= 0.94,95%CI[0.85,1.02], P=0.15) between the two groups were found.Conclusions:Patients with early rectal cancinoma received local rectum surgery had better short-term outcomes. The following worse overall survival was not found,notwithstanding LR for early rectal cancinoma was associated with more local recurrences. Therefore, LR for early rectal cancinoma would be safety and effectiveness in suitable patients.