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Updates in Surgery
Published in: Updates in Surgery 1/2021

01-02-2021 | Rectal Cancer | Review Article

Development of the ‘PREDICT’ score through a systematic review and meta-analysis of the predictive parameters for locoregional recurrence after total mesorectal excision

Authors: Sualeh Muslim Khan, Sameh Hany Emile, Samer Hani Barsom, Syed Osama Ahsan

Published in: Updates in Surgery | Issue 1/2021

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Abstract

Background

Despite robust management techniques, locoregional recurrence rates of rectal cancer are still significant. Although offering intensive follow-up has been shown to be beneficial in the early detection, it can be resource consuming. Having a robust knowledge of risk factors of locoregional recurrence will help in identification of patients who actually need intensive follow-up programs. This review aimed to identify the factors that can predict locoregional recurrence after Total mesorectal excision (TME).

Methods

We systematically reviewed PubMed, Scopus and Cochrane for relevant articles with no date restrictions while language was restricted to English. We only included articles that had either provided Hazards ratio (HR)/odds ratio (OR) or provided enough data that allowed calculation of HR/OR specifically for rectal cancer. Articles were deemed eligible if they included patients undergoing (TME).

Results

Seventeen studies (18,605 patients) published between 2002 and 2019 were included. A total of 699 patients developed locoregional recurrence at a median time of 25.2 months after surgery. There were eight significant predictors evaluated by more than one study; T3–T4 stage, circumferential resection margin, lymphovascular invasion, mucinous histology, N1–N2 stage, positive distal resection margin, Tumor < 5 cm from anal verge, and lack of neoadjuvant radiotherapy. A scoring system was developed based on the weight and pooled OR/HR of each predictor.

Conclusion

Using predictive factors identified in our review in context of scoring system may help in the early detection of locoregional recurrence after TME. This may help in tailoring the application of intensive follow-up programs.
Appendix
Available only for authorised users
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Metadata
Title
Development of the ‘PREDICT’ score through a systematic review and meta-analysis of the predictive parameters for locoregional recurrence after total mesorectal excision
Authors
Sualeh Muslim Khan
Sameh Hany Emile
Samer Hani Barsom
Syed Osama Ahsan
Publication date
01-02-2021
Publisher
Springer International Publishing
Published in
Updates in Surgery / Issue 1/2021
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI
https://doi.org/10.1007/s13304-020-00853-z

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