{
  "abstract": "Aim: Transanal total mesorectal excision (TaTME) combined with intersphincteric resection (ISR) has emerged as a sphincter‐preserving surgical option for very low rectal cancer. However, multicenter data evaluating oncological outcomes and risk factors for local recurrence (LR) following TaTME with ISR remain limited. This study aimed to evaluate oncological outcomes and identify risk factors for LR in patients undergoing TaTME with ISR.\n\nMethods: This multicenter retrospective cohort study included patients who underwent TaTME with ISR for lower rectal cancer at 26 institutions participating in the Japan Society for Laparoscopic Colorectal Surgery. Oncological outcomes and clinicopathological factors associated with LR were analyzed. Multivariable analysis was performed to identify independent risk factors for LR.\n\nResults: A total of 224 patients were included. The 3‐year LR, recurrence‐free survival (RFS), and overall survival (OS) rates were 7.3%, 79.5%, and 98.1%, respectively. Multivariable analysis identified circumferential resection margin (CRM)/radial margin (RM) positivity as the key independent risk factor for LR. In contrast, pathological features, including histopathological classification, lymphatic invasion, vascular invasion, perineural invasion, and tumor budding, reflected tumor biological aggressiveness rather than surgical performance. A biological aggressiveness score demonstrated a stepwise increase in LR risk according to the number of adverse pathological factors.\n\nConclusion: TaTME combined with ISR is a feasible sphincter‐preserving option for lower rectal cancer, with acceptable oncological outcomes in a nationwide multicenter cohort. Both surgical factors, particularly margin status, and tumor biological characteristics may contribute to LR risk. Careful margin assessment and close postoperative surveillance are essential for optimizing oncological outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Digestive Surgery Kagoshima University Graduate School of Medical Sciences Kagoshima Kagoshima Japan",
    "Division of Gastrointestinal Surgery, Department of Surgery Kobe University Graduate School of Medicine Kobe Japan",
    "Gastroenterological Surgery Osaka International Medical & Science Center Osaka Japan",
    "Department of Surgery Keio University School of Medicine Tokyo Japan",
    "Division of Gastrointestinal Surgery, Department of Surgery Asahikawa Medical University Asahikawa Japan",
    "Department of Surgery, Faculty of Medicine Saga University Saga Japan",
    "Department of Gastroenterological Surgery Tokai University School of Medicine Isehara Japan",
    "Department of Lower Gastrointestinal Surgery Kitasato University School of Medicine Sagamihara Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kan Tanabe",
      "orcid": "0000-0002-1144-4606"
    },
    {
      "affs": [
        0
      ],
      "name": "Shinichiro Mori",
      "orcid": "0000-0003-3571-9245"
    },
    {
      "affs": [
        0
      ],
      "name": "Kenji Baba",
      "orcid": "0009-0002-3929-8345"
    },
    {
      "affs": [
        1
      ],
      "name": "Takeru Matsuda",
      "orcid": "0000-0002-9541-856X"
    },
    {
      "affs": [
        2
      ],
      "name": "Ichiro Takemasa",
      "orcid": "0000-0003-1595-2453"
    },
    {
      "affs": [
        3
      ],
      "name": "Koji Okabayashi",
      "orcid": "0000-0001-8554-1137"
    },
    {
      "affs": [
        4
      ],
      "name": "Chikayoshi Tani"
    },
    {
      "affs": [
        5
      ],
      "name": "Tatsuya Manabe",
      "orcid": "0000-0002-9524-4635"
    },
    {
      "affs": [
        1
      ],
      "name": "Yoshihiro Kakeji",
      "orcid": "0000-0002-2727-0241"
    },
    {
      "affs": [
        0
      ],
      "name": "Takao Ohtsuka",
      "orcid": "0000-0002-2946-1092"
    },
    {
      "affs": [
        6
      ],
      "name": "Seiichiro Yamamoto",
      "orcid": "0000-0002-9879-1239"
    },
    {
      "affs": [
        7
      ],
      "name": "Takeshi Naitoh",
      "orcid": "0000-0003-4169-6334"
    },
    {
      "name": "Ta‐Ta‐Mi Study Group Collaborative of the Japan Society of Laparoscopic Colorectal Surgery"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ed8ztra5e1qp3.bib",
  "cited_by": 0,
  "doi": "10.1002/ags3.70304",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722975/?tool=EBI",
  "id": "ed8ztra5e1qp3",
  "issns": [
    "2475-0328"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13722975",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2730|Colorectal Cancer Surgical Treatments"
    ]
  ],
  "openalex": "W7225001679",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722975/pdf/?tool=EBI",
  "pmcid": "PMC13722975",
  "pmid": "42967081",
  "published": "2026-10-31",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/ed8ztra5e1qp3.ris",
  "sources": [
    {
      "first_seen": "2026-11-02T03:21:51Z",
      "native_id": "PMC:PMC13722975",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13722975"
    },
    {
      "first_seen": "2026-11-04T12:21:40Z",
      "native_id": "PMC13722975",
      "source": "pmc",
      "url": "https://doi.org/10.1002/ags3.70304"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Colorectal Cancer Surgical Treatments",
      "subfield": "oncology"
    }
  ],
  "title": "Local Recurrence and Oncological Outcomes After Transanal Total Mesorectal Excision With Intersphincteric Resection for Lower Rectal Cancer: A Nationwide Multicenter Cohort Study (Ta‐Ta‐Mi Study)",
  "title_text": "Local Recurrence and Oncological Outcomes After Transanal Total Mesorectal Excision With Intersphincteric Resection for Lower Rectal Cancer: A Nationwide Multicenter Cohort Study (Ta‐Ta‐Mi Study)",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T12:21:40Z",
  "url": "https://research.draconitic.com/paper/ed8ztra5e1qp3",
  "venue": "Annals of gastroenterological surgery",
  "versions": []
}