Letters nificant increase in their primary end point of oxygen satura- tion margins, were the primary outcome in the ALaCaRT and tion at 24 hours compared with control patients (99.7% [SD, ACOSOG trials. Although incompleteness of the mesorectum 1.1] vs 97.8% [SD, 1.5]; P < .001), we argue that this differ- and involved circumferential resection margins predispose to ence is of no clinical significance and falls into the range of vari- locoregional recurrence, these short-term findings cannot re- ability expected in pulse oximetry measurements. If this rig- liably substitute long-term oncological outcomes. Loco- orous and “adequate” IS use compared with no use only results regional recurrence and disease-free survival are the hall- in a difference of oxygen saturation levels of 1.9 percentage mark of cancer care. Rates of locoregional recurrence and points, we stand by our conclusions that question what util- disease-free survival 3 years after index surgery were pub- ity the real-world applications of IS has on clinical outcomes lished by the COREAN and COLOR II trial groups in 2014 and 4,5 in patients after bariatric surgery. 2015, respectively. Noninferiority of laparoscopic resec- tion of rectal cancer was clearly demonstrated with narrow con- Haddon Pantel, MD fidence intervals.
JAMA Surgery – American Medical Association
Published: Oct 28, 2017
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