Table 3.5GRADE profile: For patients presenting with locally advanced rectal cancer is preoperative chemoradiotherapy more effective than immediate surgery

Quality assessmentOther considerationsQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecision
Overall Survival (Chessinet al., 2005) (follow-up median 43.9 months1)
1observational studiesvery serious2no serious inconsistencyno serious indirectnessserious3noneVERY LOW
Overall Survival (Cocoet al., 2006) (follow-up median 108 months)
1observational studiesvery serious2no serious inconsistencyno serious indirectnessserious3noneVERY LOW
Overall Survival (Memershtainet al., 2005)
1observational studiesvery serious2no serious inconsistencyno serious indirectnessserious3noneVERY LOW
Overall Survival (Twuet al., 2009) (follow-up median 1.5 years10)
1observational studiesvery serious7no serious inconsistencyno serious indirectnessSerious8noneVERY LOW
Relapse and Disease Free Survival (Chessinet al., 2005) (follow-up median 43.9 months)
1observational studiesvery serious6no serious inconsistencyno serious indirectnessSerious7noneVERY LOW
Relapse and Disease Free Survival (Twuet al., 2009) (follow-up median 1.5 years9)
1observational studiesvery serious6no serious inconsistencyno serious indirectnessSerious7noneVERY LOW
1

Median follow-up was given under the results of post-operative morbidity. No other mention of follow-up duration was made for other outcomes, therefore it is assumed that this was the median follow up for all outcomes.

2

Not a randomised trial

3

Imprecision cannot be assessed

4

no significant difference between patients with serious post-operative morbidity and patients without (p=0.09)

5

Median follow-up time was longer than 1.5 years, but the study does not report actual median follow-up time.

6

Not a randomised trial

7

Imprecision cannot be assessed

8

Relapse free survival did not differ significantly between patients with major postoperative complications and those without (p=0.1)

9

Median follow-up time was longer than 1.5 years, but the study does not report actual median follow-up time.

10

Disease free survival was higher in the patients responding to preoperative chemoradiotherapy than in patients not responding (p=0.06)

From: 3, Management of local disease

Cover of Colorectal Cancer
Colorectal Cancer: The Diagnosis and Management of Colorectal Cancer.
NICE Clinical Guidelines, No. 131.
National Collaborating Centre for Cancer (UK).
Copyright © 2011, National Collaborating Centre for Cancer.

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