A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer

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A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer. / Bach, Simon; Hill, J; Monson, JR; Simson, JN; Lane, L; Merrie, A; Warren, B; Mortensen, NJ.

In: British Journal of Surgery, Vol. 96, No. 3, 01.03.2009, p. 280-90.

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Harvard

Bach, S, Hill, J, Monson, JR, Simson, JN, Lane, L, Merrie, A, Warren, B & Mortensen, NJ 2009, 'A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer', British Journal of Surgery, vol. 96, no. 3, pp. 280-90. https://doi.org/10.1002/bjs.6456

APA

Bach, S., Hill, J., Monson, JR., Simson, JN., Lane, L., Merrie, A., Warren, B., & Mortensen, NJ. (2009). A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer. British Journal of Surgery, 96(3), 280-90. https://doi.org/10.1002/bjs.6456

Vancouver

Author

Bach, Simon ; Hill, J ; Monson, JR ; Simson, JN ; Lane, L ; Merrie, A ; Warren, B ; Mortensen, NJ. / A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer. In: British Journal of Surgery. 2009 ; Vol. 96, No. 3. pp. 280-90.

Bibtex

@article{ddacc924f01f445d8aa27968fc905d96,
title = "A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer",
abstract = "BACKGROUND: The outcome of local excision of early rectal cancer using transanal endoscopic microsurgery (TEM) lacks consensus. Screening has substantially increased the early diagnosis of tumours. Patients need local treatments that are oncologically equivalent to radical surgery but safer and functionally superior. METHODS: A national database, collated prospectively from 21 regional centres, detailed TEM treatment in 487 subjects with rectal cancer. Data were used to construct a predictive model of local recurrence after TEM using semiparametric survival analyses. The model was internally validated using measures of calibration and discrimination. RESULTS: Postoperative morbidity and mortality were 14.9 and 1.4 per cent respectively. The Cox regression model predicted local recurrence with a concordance index of 0.76 using age, depth of tumour invasion, tumour diameter, presence of lymphovascular invasion, poor differentiation and conversion to radical surgery after histopathological examination of the TEM specimen. CONCLUSION: Patient selection for TEM is frequently governed by fitness for radical surgery rather than suitable tumour biology. TEM can produce long-term outcomes similar to those published for radical total mesorectal excision surgery if applied to a select group of biologically favourable tumours. Conversion to radical surgery based on adverse TEM histopathology appears safe for p T1 and p T2 lesions.",
author = "Simon Bach and J Hill and JR Monson and JN Simson and L Lane and A Merrie and B Warren and NJ Mortensen",
year = "2009",
month = mar,
day = "1",
doi = "10.1002/bjs.6456",
language = "English",
volume = "96",
pages = "280--90",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "Wiley",
number = "3",

}

RIS

TY - JOUR

T1 - A predictive model for local recurrence after transanal endoscopic microsurgery for rectal cancer

AU - Bach, Simon

AU - Hill, J

AU - Monson, JR

AU - Simson, JN

AU - Lane, L

AU - Merrie, A

AU - Warren, B

AU - Mortensen, NJ

PY - 2009/3/1

Y1 - 2009/3/1

N2 - BACKGROUND: The outcome of local excision of early rectal cancer using transanal endoscopic microsurgery (TEM) lacks consensus. Screening has substantially increased the early diagnosis of tumours. Patients need local treatments that are oncologically equivalent to radical surgery but safer and functionally superior. METHODS: A national database, collated prospectively from 21 regional centres, detailed TEM treatment in 487 subjects with rectal cancer. Data were used to construct a predictive model of local recurrence after TEM using semiparametric survival analyses. The model was internally validated using measures of calibration and discrimination. RESULTS: Postoperative morbidity and mortality were 14.9 and 1.4 per cent respectively. The Cox regression model predicted local recurrence with a concordance index of 0.76 using age, depth of tumour invasion, tumour diameter, presence of lymphovascular invasion, poor differentiation and conversion to radical surgery after histopathological examination of the TEM specimen. CONCLUSION: Patient selection for TEM is frequently governed by fitness for radical surgery rather than suitable tumour biology. TEM can produce long-term outcomes similar to those published for radical total mesorectal excision surgery if applied to a select group of biologically favourable tumours. Conversion to radical surgery based on adverse TEM histopathology appears safe for p T1 and p T2 lesions.

AB - BACKGROUND: The outcome of local excision of early rectal cancer using transanal endoscopic microsurgery (TEM) lacks consensus. Screening has substantially increased the early diagnosis of tumours. Patients need local treatments that are oncologically equivalent to radical surgery but safer and functionally superior. METHODS: A national database, collated prospectively from 21 regional centres, detailed TEM treatment in 487 subjects with rectal cancer. Data were used to construct a predictive model of local recurrence after TEM using semiparametric survival analyses. The model was internally validated using measures of calibration and discrimination. RESULTS: Postoperative morbidity and mortality were 14.9 and 1.4 per cent respectively. The Cox regression model predicted local recurrence with a concordance index of 0.76 using age, depth of tumour invasion, tumour diameter, presence of lymphovascular invasion, poor differentiation and conversion to radical surgery after histopathological examination of the TEM specimen. CONCLUSION: Patient selection for TEM is frequently governed by fitness for radical surgery rather than suitable tumour biology. TEM can produce long-term outcomes similar to those published for radical total mesorectal excision surgery if applied to a select group of biologically favourable tumours. Conversion to radical surgery based on adverse TEM histopathology appears safe for p T1 and p T2 lesions.

U2 - 10.1002/bjs.6456

DO - 10.1002/bjs.6456

M3 - Article

C2 - 19224520

VL - 96

SP - 280

EP - 290

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

IS - 3

ER -