Transanal total mesorectal excision (TaTME) results in “acceptable” rates of local recurrence and survival among patients with rectal cancer, according to researchers. 

The group reported these findings, from the international TaTME registry, in the Journal of the National Comprehensive Cancer Network.

The prospective registry included 2803 patients with primary rectal adenocarcinoma who underwent TaTME from February 2010 through December 2018.


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At baseline, the patients’ median age was 65 years, and 71% were men. Resection was complete in 86% of patients, 3% had major defects in the mesorectum, and 7% had an incomplete resection. Overall, 90% of patients had an optimal pathologic outcome.

The median follow-up was 24 months. The 2-year actuarial rate of local recurrence was 4.8%. Most patients (96%) with local recurrence had a unifocal pattern. 

The researchers noted that these results “compare favorably” with published 2-year local recurrence rates after laparoscopic and open total mesorectal excision. 

Factors that were independently associated with local recurrence in a multivariate analysis included:

  • Male sex (odds ratio [OR], 1.62; 95% CI, 1.05-2.48; P =.029)
  • Threatened mesorectal fascia on baseline MRI (OR, 1.54; 95% CI, 1.06-2.25; P =.024)
  • Pathologic stage III disease (OR, 2.12; 95% CI, 1.48-3.04; P <.001)
  • Positive circumferential resection margin on final histopathology (OR, 2.27; 95% CI, 1.31-3.94; P =.004).

The 2-year actuarial disease-free survival rate was 76.6%, and the 2-year actuarial overall survival rate was 91.9%.

The researchers concluded that this study “supports the oncologic safety of the TaTME technique for rectal cancer.” 

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Roodbeen SX, Penna M, van Dieren S, et al. Local recurrence and disease-free survival after transanal total mesorectal excision: Results from the international TaTME registry. J Natl Compr Canc Netw. Published online August 17, 2021. doi:10.6004/jnccn.2021.7012

This article originally appeared on Cancer Therapy Advisor