Annals of surgery
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Randomized Controlled Trial Multicenter Study Comparative Study
Surgical Quality Assurance in COLOR III: Standardization and Competency Assessment in a Randomized Controlled Trial.
The aim of this study was to develop an objective and reliable surgical quality assurance system (SQA) for COLOR III, an international multicenter randomized controlled trial (RCT) comparing transanal total mesorectal excision (TaTME) with laparoscopic approach for rectal cancer. ⋯ We described an iterative approach to develop an objective SQA within multicenter RCT. This approach provided standardization, the development of reliable and valid CAT, and the criteria for trial entry and monitoring surgical performance during the trial.
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Randomized Controlled Trial Multicenter Study
Does A Longer Waiting Period After Neoadjuvant Radio-chemotherapy Improve the Oncological Prognosis of Rectal Cancer?: Three Years' Follow-up Results of the Greccar-6 Randomized Multicenter Trial.
The aim of this study was to report the 3-year survival results of the GRECCAR-6 trial. ⋯ Extending the waiting period by 4 weeks following RCT has no influence on the oncological outcomes of T3/T4 rectal cancers.
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To assess the adoption of recommendation from randomized clinical trials (RCTs) and investigate factors favoring or preventing adoption. ⋯ In conclusion, surgical RCTs appear to have moderate impact on daily surgical practice. While RCTs are still accepted to provide the highest level of evidence, alternative methods of evaluating surgical innovations should also be explored.
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The aim of this study was to determine the incidence of, and preoperative risk factors for, positive circumferential resection margin (CRM) after transanal total mesorectal excision (TaTME). ⋯ Five preoperative tumor-related characteristics had an adverse effect on CRM involvement after TaTME. The predicted risk of positive CRM after TaTME for a specific patient can be calculated preoperatively with the proposed model and may help guide patient selection for optimal treatment and enhance a tailored treatment approach to further optimize oncological outcomes.
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Multicenter Study
Pelvic Exenteration for Advanced Nonrectal Pelvic Malignancy.
To determine factors associated with outcomes following pelvic exenteration for advanced nonrectal pelvic malignancy. ⋯ Pelvic exenteration remains an important treatment in selected patients with advanced or recurrent nonrectal pelvic malignancy. The range in 3-year overall survival following R0 resection (40%-59%) reflects the diversity of tumor types.