Role of minimally invasive surgery for rectal cancer

Table 3 Major randomized controlled trials in minimally invasive surgery for rectal cancer

Trial	Year	Comparison	Enrollment	Primary end point	Findings
MRC CLASICC[6]	2005	Lap vs Open	253 vs 128	Clear margins/mortality	Colon and rectal surgery compared, 12% vs 6% positive CRM
MRC CLASICC FU[81]	2013				No differences seen OS, DFS, LR at 62 mo
COREAN[7]	2010	Lap vs Open	170 vs 170		No differences seen in multiple short-term outcomes
COREAN FU[82]	2014			3-yr disease free survival	Noninferiority of laparoscopic approach was met, 79% vs 72% DFS
COLOR II[32]	2013	Lap vs Open	699 vs 345		Similar safety and margins, laparoscopic surgery had quicker recovery
COLOR II FU[8]	2015			3-yr locoregional recurrence	Similar recurrence rates at 5% for each group
ACOSOG Z6051[9]	2015	Lap vs Open	240 vs 222	Clear margins	Noninferiority study not able to reach boundary of 6%
ACOSOG Z6051 FU[11]	2019				No differences seen in long term oncologic outcomes
ALaCaRT[10]	2015	Lap vs Open	238 vs 237	Clear margins	Noninferiority study not able to reach boundary of 8%
ALaCaRT FU[12]	2019				No differences seen in long term oncologic outcomes
ROLARR[15]	2017	Lap vs Robot	234 vs 237	Conversion to open surgery	No differences seen in conversion rate, 12% vs 8%
Kim et al[16]	2018	Lap vs Robot	73 vs 66	Completeness of TME	Similar TME specimens, 78% vs 80%
Bordeaux[17]	2014	Lap vs TaTME	50 vs 50	Quality of oncologic surgery	Significant decrease in CRM positivity for TaTME, 4% vs 18%
Bordeaux FU[54]	2018				No differences seen in long term oncologic outcomes at 60 months

FU: Follow up study; TME: Total mesorectal excision; TaTME: Transanal TME; CRM: Circumferential resection margin; OS: Overall survival; DFS: Disease-free survival.