TY - JOUR
AU - Remzi, F
AB - Editor We read with interest the audit by van Oostendorp et al.1 evaluating patterns and risk factors of local recurrence in the first ten transanal total mesorectal excision (TaTME) cases performed in 12 centres (10 in each centre: first five proctored, second five independent) for rectal cancer. The pooled local recurrence rate was reported as 10 per cent (7 per cent in proctored and 13 per cent in non-proctored halves), mostly multifocal. Although we appreciate the work behind the study and the honest report, we feel that we would be contributing to the external validity of the core message by adding the following comments: (1) the reported 10 per cent recurrence rate may actually have been underestimated. In fact, half of all recurrences occurred in four institutions (performing more than 45 procedures each). The pooled recurrence rate in the first 10 cases was 15 per cent. Moreover, the lower limit of the range of follow-up was reported as 2 months; (2) the use of univariate analysis to determine risk factors for multifocal local recurrence may have underestimated confounders. In fact, proctoring, which was not considered a factor, could have been a confounder; and (3) the data provided in Table 6 comparing the first 10 with subsequent cases in the same four institutions seem to suggest improved recurrence rates. However, case sequence analysis is not an appropriate methodology to evaluate learning2. In conclusion, the audit by van Oostendorp et al. seems to corroborate the multifocal local recurrence rates reported by Wasmuth et al.3, and provides additional evidence supporting the sunk cost fallacy of advocating for TaTME4. References 1 van Oostendorp SE , Belgers HJ, Bootsma BT, Hol JC, Belt EJTH, Bleeker W et al. . Locoregional recurrences after transanal total mesorectal excision of rectal cancer during implementation . Br J Surg 2020 ; https://doi.org/10.1002/bjs.11525 [Epub ahead of print]. Google Scholar OpenURL Placeholder Text WorldCat 2 Gachabayov M , Rojas A, Bergamaschi R. Is case sequence analysis an objective assessment of learning curve? Dis Colon Rectum 2020 ; 63 : e23. Google Scholar OpenURL Placeholder Text WorldCat 3 Wasmuth HH , Faerden AE, Myklebust TÅ, Pfeffer F, Norderval S, Riis R et al. . Transanal total mesorectal excision for rectal cancer has been suspended in Norway . Br J Surg 2020 ; 107 : 121 – 130 . Google Scholar Crossref Search ADS PubMed WorldCat 4 Arkes HR , Hutzel L. The role of probability of success estimates in the sunk cost effect . J Behav Decis Mak 2000 ; 13 : 295 – 306 . Google Scholar Crossref Search ADS WorldCat © 2020 BJS Society Ltd Published by John Wiley & Sons Ltd This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) © 2020 BJS Society Ltd Published by John Wiley & Sons Ltd
TI - Evidence supporting the sunk cost fallacy of advocating for transanal total mesorectal excision
JO - British Journal of Surgery
DO - 10.1002/bjs.11718
DA - 2020-06-07
UR - https://www.deepdyve.com/lp/oxford-university-press/evidence-supporting-the-sunk-cost-fallacy-of-advocating-for-transanal-UpTaWzWjjn
SP - e347
EP - e347
VL - 107
IS - 9
DP - DeepDyve
ER -