# Long-term oncological outcomes of laparoscopic versus transanal total mesorectal excision for mid-low rectal cancer: a propensity score matching analysis

## TL;DR

This study compares long-term cancer outcomes of two surgical approaches for rectal cancer and finds they are equally effective.

## Contribution

The novelty lies in demonstrating comparable oncological outcomes between taTME and lapTME using propensity score matching.

## Key findings

- Five-year overall survival rates were comparable between taTME and lapTME groups before and after PSM.
- Disease-free survival rates were also similar between the two surgical approaches.
- taTME achieved comparable oncological safety to lapTME for mid-low rectal cancer patients.

## Abstract

Transanal total mesorectal excision (taTME) has become a promising surgical approach for anus-preserving surgery of mid-low rectal cancer (RC). This study aimed to compare the long-term oncological outcomes of taTME and laparoscopic total mesorectal excision (lapTME).

Of 233 patients who were treated for mid-low RC from July 2017 to August 2020, 110 underwent taTME and 123 received lapTME. Propensity score matching (PSM) was performed to balance the baseline characteristics between the taTME and lapTME groups. After PSM, 61 patients were included in each group.

Prior to PSM, the 5-year overall survival (OS) and disease-free survival (DFS) rates were comparable between the taTME and lapTME groups (72.7% vs. 69.1%, p = 0.617; 72% vs. 69%, p = 0.576, respectively). After PSM, there was no statistically significant difference in the 5-year OS and DFS rates between groups (64.2% vs. 64.4%, p = 0.936; 66.1% vs. 66.1%, p = 0.947, respectively).

As compared to lapTME, taTME achieved comparable oncological safety for patients with mid-low RC.