Meta-analysis of surgical quality-related factors associated with local recurrence rate after rectal cancer surgery

Figure 6 Association of operative time and circumferential resection margin status with oncological outcomes. A: Prolonged operative time exceeding 240 minutes was associated with increased local recurrence risk (odds ratio = 1.52); however, meta-regression showed that this association was attenuated after controlling for total mesorectal excision quality (P = 0.18), suggesting that operative time may reflect technical difficulty rather than serve as an independent risk factor; B: Positive circumferential resection margin was associated with significantly worse disease-free survival [DFS; hazard ratio (HR) = 2.84; 5-year DFS 42.3% vs 71.8%] and overall survival (OS; HR = 2.56; 5-year OS 48.7% vs 76.4%) compared with negative circumferential resection margin. 95%CI: 95% confidence interval.