{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:17:18Z","timestamp":1787563038674,"version":"build-2736575974"},"reference-count":60,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Worldwide, of all cancers, colorectal cancer has the fourth highest rate of mortality. Curative treatment for locally advanced or recurrent rectal cancer can require extended resections with sacrectomy, but this sugery can have major consequences for patients. The aim of this study was to investigate the oncological and functional outcomes after sacrectomy in patients with colorectal cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>The protocol was registered in (PROSPERO), the international prospective register of systematic reviews. PubMed, Embase, The Cochrane Library, Scopus and Google Scholar were searched using a predetermined search strategy. Article selection, quality of evidence [Grading of Recommendation, Assessment, Development and Evaluation (GRADE)] and risk of bias [The Risk Of Bias In Non\u2010randomized Studies\u2014of Interventions (ROBINS\u2010I)] were assessed by two independent reviewers. Studies reporting on sacrectomy for colorectal cancer were included. Oncological and functional outcomes after sacrectomy for colorectal cancer were the primary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010six articles with 1687 patients (1115 men; 506 women) were included. Median follow\u2010up was 31.4\u2009months. Mean 30\u2010day mortality was 1.1%. After R0 resection, overall survival was achieved in 86.2%, 68.0% and 42.1% patients, and disease\u2010free survival was achieved in 75.0%, 51.0% and 43.0% patients, respectively, after 1, 3 and 5\u2009years. Survival rates were lower after R1 or R2 resection. Most patients reported elimination of or significantly reduced pain after surgery, and 82.2% were able to walk independently, without the use of assistive devices. More patients were dependent on walking\u2010assist devices after high sacrectomy than after low sacrectomy. The most commonly reported bowel dysfunctions were bowel obstruction (22.3%) and fistula (4.6%). Bladder dysfunction was mainly reported as incontinence (8.3%) and neurogenic bladder (23.3%). No study included quality of life as an outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The mortality was limited, and the morbidity rates were in concordance with published literature. The results suggest that R0 resection has higher survival rates than R1\/R2 resections. Both short\u2010 and long\u2010term functional outcomes could have major impact on a patient's quality of life. Heterogeneity was high, and neither comparative analyses nor meta\u2010analysis could be performed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70083","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T16:36:57Z","timestamp":1743871017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Oncological and functional outcomes after sacrectomy for colorectal cancer: A systematic review"],"prefix":"10.1111","volume":"27","author":[{"given":"Nathalie","family":"Braeckman","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery Ghent University Hospital  Ghent Belgium"},{"name":"Ghent University Hospital  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Kerckhove","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery Ghent University Hospital  Ghent 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