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This is a narrative review synthesizing evidence across multiple preoperative colorectal cancer strategies, providing decision boundaries and clinical recommendations rather than reporting original trial data.
Single-case report of an individualized treatment strategy in ultra-low rectal cancer, documenting feasibility of sphincter preservation and bowel function recovery but lacking comparative data or generalizability.
A retrospective cohort study with adequate sample size and long follow-up (median 63 months) reporting a clinically meaningful primary endpoint (delayed re-stoma-free survival), but lacks a comparator group and prospective design; results support the durability of sphincter-preserving surgery but require confirmation in prospective studies.
A retrospective single-center study using cross-validation in a small, heterogeneous cohort (152 patients, split by treatment) that reports surrogate endpoints (AUC) rather than clinical outcomes; radiomic findings did not improve on baseline models, limiting clinical utility.
Meta-analysis of public transcriptomic data identifying candidate biomarkers and immune signatures associated with neoadjuvant response in rectal cancer, but without clinical validation, prospective design, or outcome prediction model.
Retrospective single-centre cohort with modest follow-up (1.4 years median) and no randomization; observational associations with biomarkers and treatment types are hypothesis-generating rather than definitive.
A narrative framework review synthesizing evidence on technical difficulty, surgical quality assessment, and AI-enabled audit for minimally invasive D2 lymphadenectomy, proposing guidance for quality measurement and process review.