Evidence map›Paper›PMID 42528735›Full record

SynthesisFrontiers in oncology2026

Current evidence on the management of re-recurrent rectal cancer: a systematic review.

Georgios Giannos, Panagiotis Theodoropoulos, Maximos Frountzas, Sheng Qiu, Maria Katsigeorgis, Sophia Y Chen, Shahnawaz Rasheed, Paris Tekkis, Bashar Safar, Christos Kontovounisios

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Georgios Giannos2nd Surgical Department, Hygeia Hospital, Athens, Greece.
Panagiotis Theodoropoulos2nd Surgical Department, Hygeia Hospital, Athens, Greece.
Maximos FrountzasDepartment of Colorectal Surgery, Royal Marsden Hospital, London, United Kingdom.
Sheng QiuDepartment of Colorectal Surgery, Royal Marsden Hospital, London, United Kingdom.
Maria KatsigeorgisDivision of Colon and Rectal Surgery, Department of Surgery, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States.
Sophia Y ChenDivision of Colon and Rectal Surgery, Department of Surgery, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States.
Shahnawaz RasheedDepartment of Colorectal Surgery, Royal Marsden Hospital, London, United Kingdom.
Paris TekkisDepartment of Colorectal Surgery, Royal Marsden Hospital, London, United Kingdom.
Bashar SafarDivision of Colon and Rectal Surgery, Department of Surgery, NYU Grossman School of Medicine, NYU Langone Health, New York, NY, United States.
Christos Kontovounisios2nd Surgical Department, Hygeia Hospital, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Re-recurrent rectal cancer (RRRC) represents a highly complex disease following curative-intent treatment of recurrent rectal cancer (RRC). While management principles for primary and locally recurrent rectal cancer (RRC) have been defined by expert collaborations, no specific guidelines currently outline the perioperative management of RRRC. This systematic review aimed to appraise the reported perioperative strategies and oncological outcomes of patients undergoing curative-intent treatment for RRRC. Methods: Eligibility criteria, Studies reporting perioperative management and outcomes of adult patients undergoing curative-intent treatment for RRRC were included. Non-English articles, letters, abstracts, and studies lacking surgical or oncological data were excluded. Information sources, The review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD420251244390). MEDLINE (PubMed), Cochrane Library, Web of Science, and Scopus were searched for relevant articles. Risk of bias, Methodological quality was assessed using the Newcastle-Ottawa Scale for cohort studies. Synthesis of results, Given heterogeneity in treatment strategies and outcome reporting, results were synthesized narratively. Results: Included studies, Three retrospective cohort studies comprising 169 patients treated with curative intent surgery for RRRC were included. Synthesis of results, Neoadjuvant therapy was administered in 20-92% of included patients, depending on the previous cumulative radiation dose. Pelvic exenteration was frequently required, with total exenteration performed in 6-20% and sacrectomy in up to 15% of cases; reconstructive procedures were reported in less than 16%. IORT was used in 44-77% of patients in centers where it was available. R0 resection rates ranged from 33% to 62%, with oncological outcomes directly associated with margin status. Discussion: Limitations of evidence, Evidence was limited to retrospective observational studies with small sample sizes, heterogeneous management, and varied institutional resources, precluding meta-analysis. Interpretation, Curative-intent surgery for RRRC is feasible in highly selected patients, with R0 being the principal prognostic determinant of oncological outcome. However, significant variability in perioperative pathways, margin definition, MRI-based classification, and reconstructive strategies underlines the necessity for the development of standardized, consensus-based recommendations to optimize multidisciplinary treatment. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251244390, identifier CRD420251244390.

Indexed as

plastic-reconstructionre-chemotherapyre-irradiationre-recurrent pelvic cancerre-recurrent rectal cancerre-resectionsecond recurrencesurvival

Identifiers

PMID42528735
PMCPMC13414183

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.