Table 1. Preoperative and Short-Term Secondary Outcomes.
| Characteristics and treatments | Outcome | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Tolerability of treatment | Toxic effects of treatmenta | Dropped out for any reason | Treatment-related deaths | Underwent surgery | Rate of R0 | Rate of negative CRM | Rate of ypN0 | Severe postoperative complicationsb | Anastomotic leak | |
| Network characteristics | ||||||||||
| Studies, No. | 25 | 22 | 27 | 24 | 27 | 18 | 11 | 21 | 9 | 17 |
| Participants, No. | 11 987 | 11 568 | 13 383 | 11 963 | 13 413 | 9145 | 4963 | 10 070 | 3525 | 8333 |
| τ2 | 0.007 | 0.080 | 0.003 | 0 | <0.001 | <0.001 | 0.008 | 0.002 | 0.006 | 0 |
| Consistency | ||||||||||
| CnG, Cochran Q; df | 3.73; 6 | 2.00; 4 | 8.56; 6 | 0.98; 6 | 8.50; 6 | 4.55; 5 | 11.68; 1 | 6.19; 4 | 2.50; 1 | 4.88; 5 |
| P value | .71 | .74 | .20 | .99 | .20 | .47 | <.001 | .18 | .11 | .43 |
| CnL, comparisons, No./total No.c | 0/10 | 0/8 | 0/10 | 0/10 | 0/10 | 0/9 | 3/3 | 0/8 | 0/3 | 0/9 |
| Comparison vs L-CRT1, RR (95% CI) | ||||||||||
| L-CRT + consolidation | 0.93 (0.86-1.03) | 1.65 (0.93-2.93) | 1.03 (0.51-2.09) | 1.19 (0.29-4.93) | 1.01 (0.96-1.06) | 0.95 (0.87-1.03) | 1.00 (0.83-1.20) | 1.14 (0.98-1.33) | 0.99 (0.53-1.83) | 1.04 (0.21-5.07) |
| S-RT + consolidation | 0.90 (0.82-0.99)d | 2.01 (1.39-2.91)d | 0.91 (0.67-1.23) | 0.71 (0.25-1.99) | 1.02 (0.98-1.05) | 1.04 (0.99-1.09) | 1.03 (0.85-1.25) | 1.08 (1.00-1.18)d | 0.92 (0.61-1.41) | 1.29 (0.63-2.63) |
| Induction + L-CRT | 0.95 (0.86-1.06) | 1.64 (1.05-2.56)d | 1.42 (0.76-2.66) | 1.30 (0.35-4.77) | 0.99 (0.96-1.03) | 0.97 (0.91-1.03) | 1.05 (0.91-1.22) | 1.08 (0.96-1.22) | NA | 0.90 (0.53-1.52) |
| L-CRT2 | 0.91 (0.86-0.97)d | 1.81 (1.44-2.27)d | 1.14 (0.88-1.50) | 1.48 (0.76-2.88) | 0.99 (0.98-1.01) | 1.00 (0.97-1.02) | 1.02 (0.90-1.16) | 1.02 (0.95-1.09) | 1.13 (0.87-1.47) | 1.08 (0.85-1.36) |
| CHT | 1.01 (0.91-1.11) | 1.67 (1.04-2.64)d | 1.05 (0.74-1.48) | 1.90 (0.49-7.39) | 0.99 (0.96-1.03) | 1.00 (0.96-1.04) | 1.01 (0.84-1.22) | 0.93 (0.85-1.02) | NA | 0.62 (0.39-0.96)d |
| S-RTdelayed | NA | NA | 2.33 (0.60-9.07) | NA | 0.94 (0.86-1.03) | 0.89 (0.76-1.05) | 0.94 (0.74-1.18) | 0.80 (0.62-1.03) | NA | 0.85 (0.24-3.02) |
| L-RT | 1.23 (1.10-1.40)d | 0.19 (0.08 to 0.44)d | 0.59 (0.33-1.08) | 1.01 (0.14-7.17) | 1.02 (0.99-1.04) | NA | NA | 0.92 (0.83-1.01) | NA | 1.00 (0.48-2.06) |
| S-RTearly | 1.05 (0.88-1.25) | 0.12 (0.05-0.28)d | 0.50 (0.23-1.06) | 0.68 (0.11-4.12) | 1.02 (0.98-1.06) | 1.00 (0.93-1.07) | 0.94 (0.76-1.16) | 0.94 (0.77-1.14) | 1.39 (0.68-2.82) | 1.74 (0.52-5.82) |
Abbreviations: CHT, chemotherapy; CnG, consistency–global test; CnL, consistency–local test; CRM, circumferential resection margin; induction + L-CRT, induction CHT plus consolidation long-course chemoradiotherapy; L-CRT + consolidation, L-CRT plus consolidation CHT; L-CRT1, L-CRT with single-agent fluoropyrimidine-based CHT; L-CRT2, L-CRT with duplex CHT drug (fluoropyrimidine plus oxaliplatin); L-RT, long-course radiotherapy; NA, not available; R0, potentially curative resections; RR, relative risk; S-RT + consolidation, short-course RT plus consolidation CHT; S-RTdelayed, S-RT plus delayed rectal resection; S-RTearly, S-RT plus early rectal resection; ypN0, node-negative tumor on a pathological examination.
Rate of participants experiencing chemotherapy- or radiotherapy-associated adverse events of grade 3 or above, in which adverse events were assessed and graded from 1 to 5 by the investigators using Common Terminology Criteria for Adverse Events, version 4, with grade 5 indicating death.
Graded as Clavien-Dindo grade III or above; scores range from grades I to V, with higher numbers indicating more severe adverse events.23
The denominator is the total number of comparisons included in the analysis; the numerator is the number of inconsistencies between direct and indirect estimates.
Significant RR (95% CI).