Long-term Oncological Outcomes of Transanal Total Mesorectal Excision in Rectal Cancer: A Retrospective Study from a High-Volume Italian Center

IF 2.7 3区医学 Q2 ONCOLOGY

Clinical colorectal cancer Pub Date : 2026-03-01 Epub Date: 2025-10-21 DOI:10.1016/j.clcc.2025.10.003

Roberto Persiani, Flavio Tirelli, Laura Lorenzon, Ilaria Neri, Annamaria Agnes, Massimo Pascariello, Gloria Santoro, Alberto Biondi

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引用次数: 0

Abstract

Background

Despite the documented technical advantages in terms of pelvis dissection and increased rate of sphincter-preserving procedures, the long-term oncological outcomes after transanal total mesorectal excision (TaTME) are still a matter of debate. This study aimed to report mid- and long-term survival outcomes of patients with rectal cancer treated with TaTME.

Methods

Patients with non-metastatic mid to low rectal adenocarcinoma who underwent double-team trans-anal/laparoscopic trans-abdominal total mesorectal excision between 2015 and 2020 were selected and reviewed. Three and 5-year overall survival (OS), 3 and 5-year disease-free survival (DFS), 3 and 5-year disease-specific survival (DSS), and 3 and 5-year local recurrence (LR) rate. Univariable and multivariable analyses were performed to correlate clinical and pathological variables with the outcomes of interest.

Results

Of 146 patients treated with TaTME during the study period, 114 non-metastatic patients were analyzed (M/F 1.7; mean age: 69.1 years). The mean follow-up time was 58.6 months. Sixty four percentage received neoadjuvant treatment before TaTME. Pathologic stages were documented as being stage 0-I in 62 (54.4%) and stage II-III in the remaining 52 patients (45.6%); 5 patients had a positive circumferential margin (4.4%), and overall, one-third of the cohort received adjuvant therapy. 3-year survival outcomes were: OS 89.4%, DFS 95.5%, DSS 85.5%, and LR 3.5%.

The multivariable analysis of the 3-year outcomes showed a significant association between OS and age at the time of surgery and between DFS and pathological stages. A 5-year survival analysis was conducted on 68 patients. 5-year survivals were OS 75.0%, DFS 91.0%, and DSS 82.0%. Multivariate analysis showed that elderly age had a negative impact on 5-year OS.

Conclusions

When performed by experienced surgeons in a high-volume center, TaTME is a mini-invasive procedure with good mid/long-term oncological outcomes.

查看原文本刊更多论文

经肛门直肠全肠系膜切除术治疗直肠癌的长期肿瘤预后：来自意大利一个大容量中心的回顾性研究。

背景：尽管在骨盆解剖和保留括约肌手术方面有文献记录的技术优势，经肛直肠全肠系膜切除术（TaTME）后的长期肿瘤预后仍然存在争议。本研究旨在报告TaTME治疗直肠癌患者的中期和长期生存结果。方法：选取2015 - 2020年间行双组经肛/腹腔镜经腹全肠系膜切除术的非转移性中低位直肠腺癌患者进行回顾性分析。3年和5年总生存（OS）、3年和5年无病生存（DFS）、3年和5年疾病特异性生存（DSS）、3年和5年局部复发率（LR）。进行单变量和多变量分析，将临床和病理变量与感兴趣的结果联系起来。结果：在研究期间接受TaTME治疗的146例患者中，分析了114例非转移性患者（M/F 1.7，平均年龄：69.1岁）。平均随访时间58.6个月。64%的患者在TaTME前接受了新辅助治疗。62例（54.4%）的病理分期为0-I期，其余52例（45.6%）为II-III期；5例患者周缘阳性（4.4%），总体而言，三分之一的队列接受了辅助治疗。3年生存率：OS 89.4%, DFS 95.5%, DSS 85.5%, LR 3.5%。3年结果的多变量分析显示，OS与手术时的年龄以及DFS与病理分期之间存在显著相关性。对68例患者进行5年生存分析。5年生存率为OS 75.0%, DFS 91.0%, DSS 82.0%。多因素分析显示，年龄对5年OS有负面影响。结论：当由经验丰富的外科医生在大容量中心进行TaTME手术时，TaTME是一种微创手术，具有良好的中长期肿瘤预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical colorectal cancer 医学-肿瘤学

CiteScore

5.50

自引率

2.90%

发文量

审稿时长

27 days

期刊介绍： Clinical Colorectal Cancer is a peer-reviewed, quarterly journal that publishes original articles describing various aspects of clinical and translational research of gastrointestinal cancers. Clinical Colorectal Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of colorectal, pancreatic, liver, and other gastrointestinal cancers. The main emphasis is on recent scientific developments in all areas related to gastrointestinal cancers. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.