Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Gastrointest Surg. Aug 27, 2026; 18(8): 119417
Published online Aug 27, 2026. doi: 10.4240/wjgs.119417
Published online Aug 27, 2026. doi: 10.4240/wjgs.119417
Meta-analysis of surgical quality-related factors associated with local recurrence rate after rectal cancer surgery
Jin-Kai Wang, Hua-Bin Cheng, Department of Gastrointestinal Surgery, The Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong Province, China
Chang-Tao Yu, Department of General Surgery, The Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong Province, China
Bai-Xue Qin, Center of Digestive Endoscopy, The Second People's Hospital of Liaocheng, Liaocheng 252600, Shandong Province, China
Co-first authors: Jin-Kai Wang and Chang-Tao Yu.
Author contributions: Wang JK and Yu CT contributed equally to this work as co-first authors; Wang JK and Yu CT were responsible for the conception and design of the study, literature search and data extraction, statistical analysis, and drafting of the manuscript; Qin BX participated in data verification and critical revision of the manuscript for important intellectual content; Cheng HB, as the corresponding author, provided overall supervision, guided the study design, and gave final approval of the version to be submitted for publication; and all authors read and approved the final manuscript.
AI contribution statement: No AI tools were used in the preparation of this manuscript, including for language polishing, structural optimization, code assistance, or literature organization. All aspects of this manuscript, including study design, data analysis, results, discussion, conclusions, and references, were completed solely by the authors. The authors accept full responsibility for the accuracy, originality, and integrity of all content in this manuscript.
Conflict-of-interest statement: All authors declare that they have no conflict of interest related to this study.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Corresponding author: Hua-Bin Cheng, MD, Department of Gastrointestinal Surgery, The Second People's Hospital of Liaocheng, No. 306 Health Street, Liaocheng 252600, Shandong Province, China. chb936215@163.com
Received: March 17, 2026
Revised: June 1, 2026
Accepted: June 26, 2026
Published online: August 27, 2026
Processing time: 152 Days and 6 Hours
Revised: June 1, 2026
Accepted: June 26, 2026
Published online: August 27, 2026
Processing time: 152 Days and 6 Hours
Core Tip
Core Tip: Positive circumferential resection margin identifies patients at 4.3-fold increase risk of local recurrence emergence as strongest predictor; whereas incomplete total mesorectal excision confers 3.2-fold increased risk. Recurrence rates are significantly lower at high-volume surgeons and centers. This highlights the need for surgical quality assurance programs, specialization in rectal cancer surgery and centralization of treatment to further improve oncological results. While the meta-analysis by does not explicitly test a centralization policy, its findings align with what one would expect based on the rationale for quality-based referral patterns and training initiatives.