Multicenter phase 3 trial of 3-year disease-free rates after transanal versus laparoscopic total mesorectal excision for rectal cancer

The long-term oncological outcomes of transanal total mesorectal excision (TME) for rectal cancer are not clear. The phase 3 TaLaR trial, at 16 centers in China, compared transanal TME versus laparoscopic TME among patients with clinical stage I to III mid-low rectal cancer. The transanal TME group exhibited 3-year disease-free survival rate of 82.1%, compared with 79.4% in the laparoscopic TME group. The 3-year local recurrence rate was 3.6% in the transanal TME group, compared with 4.4% in the laparoscopic TME group. Three-year overall survival rate was 92.6% in the transanal TME group and 90.7% in the laparoscopic TME group. The authors conclude that in patients with stage I to III mid-low rectal cancer, three-years outcomes with transanal TME were noninferior to the outcomes of laparoscopic TME (visual abstract).