What do systematic reviews say?

Preoperative radiotherapy vs surgery

Preoperative radiotherapy probably leads to lower overall mortality ( compared with surgery alone (moderate certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  Peto OR 0.9 [0.83, 0.98]
  4 studies · 4663 participants
  Moderate

Preoperative radiotherapy vs surgery

Preoperative radiotherapy showed no clear difference in overall mortality ‐ only total mesorectal excision ( compared with surgery alone (low certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  Peto OR 0.97 [0.87, 1.08]
  2 studies · 3211 participants
  Low

Preoperative radiotherapy vs surgery

Preoperative radiotherapy showed no clear difference in cause‐specific mortality ( compared with surgery alone (low certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  Peto OR 0.89 [0.77, 1.03]
  2 studies · 2145 participants
  Low

Preoperative radiotherapy vs surgery

Preoperative radiotherapy probably leads to lower local recurrence ( compared with surgery alone (moderate certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  Peto OR 0.48 [0.4, 0.57]
  4 studies · 4663 participants
  Moderate

Preoperative radiotherapy vs surgery

Preoperative radiotherapy showed no clear difference in curative resection ( compared with surgery alone (low certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  RR 1 [0.97, 1.02]
  4 studies · 4673 participants
  Low

Preoperative radiotherapy vs surgery

Preoperative radiotherapy showed no clear difference in sphincter preservation ( compared with surgery alone (low certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  RR 0.99 [0.94, 1.04]
  3 studies · 4379 participants
  Low

Preoperative radiotherapy vs surgery

Preoperative radiotherapy may leads to higher postoperative morbidity ‐ sepsis (within 30 days after surgery) compared with surgery alone (low certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  RR 1.25 [1.04, 1.52]
  2 studies · 2698 participants
  Low

Preoperative radiotherapy vs surgery

Preoperative radiotherapy may leads to higher postoperative morbidity ‐ surgical complications (within 30 days… compared with surgery alone (low certainty).

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  RR 1.2 [1.01, 1.42]
  2 studies · 2698 participants
  Low

Preoperative radiotherapy vs surgery

• Preoperative radiotherapy and curative surgery for the management of localised rectal carcinoma 2018 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 3211 participants
  Low

Combination chemotherapy vs single‐agent chemotherapy

Combination chemotherapy probably leads to lower radiotherapy compliance compared with single‐agent chemotherapy (moderate certainty).

• Combination chemotherapy versus single‐agent chemotherapy during preoperative chemoradiation for resectable rectal… 2015 · Cochrane Headline outcomes only
  OR 0.32 [0.14, 0.75]
  3 studies · 2567 participants
  Moderate