The Feasibility Of Local Resection After Neoadjuvant Chemoradiotherapy Of Rectal Cancer

Objective:To study the oncological results of local resection after neoadjuvant chemoradiotherapy.Methods : The databases included CNKI,WanFang,EMbase,Cochrane Library,PubMed were retrieved.Studies providing local resection after neoadjuvant chemoradiotherapy were included.Primary outcome measures were local recurrence,DFS and morbidity.Results: 17 studies described 769 patients.The pooled local recurrence rate was 2.6%(95% CI,1.2%-4.5%)for ypT0,7.5%(95% CI,3.0%-13.7 %)for ypT1,17.4%(95% CI,11.2%-24.7 %)for ypT2,47.4%(95% CI,16.9%-79.0%)for ypT3,3.4%(95% CI,1.6%-6.0 %)for ypT0-1,21.0%(95% CI,11.7%-32.1 %)for ypT2-3,respectively.The overall median disease-free survival rate of 82%(range 68%-97%).Pooled incidence of complications was 16.5%(95% CI,10.4%-23.5%).Conclusion: Local resection after neoadjuvant chemoradiotherapy can play a therapeutic role in patients with ypT0-1.In patients with ypT2-3,local excision may be considered as an extended excisional biopsy,and aradical surgery is needed.