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Pathologic Outcomes of Laparoscopic vs Open Mesorectal Excision For Rectal Cancer—Reply

Pathologic Outcomes of Laparoscopic vs Open Mesorectal Excision For Rectal Cancer—Reply 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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Pathologic Outcomes of Laparoscopic vs Open Mesorectal Excision For Rectal Cancer—Reply

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Publisher
American Medical Association
Copyright
Copyright 2017 American Medical Association. All Rights Reserved.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/jamasurg.2017.1725
Publisher site
See Article on Publisher Site

Abstract

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.

Journal

JAMA SurgeryAmerican Medical Association

Published: Oct 28, 2017

References

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