Introduction
Rectal cancer
MALIGNANT TUMORS, RECURRENCE, RECTAL CANCER, RECTAL CANCER
Rectal cancer (RC) is one of the most common malignant tumors in the worldTraditional TME surgery required dissection anterior to Denonvilliers’ fascia (DVF) and thus DVF should be partly resectedWith studies on both cadavers and surgical videos, we demonstrated a surgical landmark line for intraoperative identification of DVFThus, we, together with the Chinese Postoperative Urogenital Function (PUF) Research Collaboration Group, conducted a prospective, multicenter, randomized clinical trial (PUF-01) to evaluate the safety and effect of DVF preservation during laparoscopic TME on postoperative urogenital function protection and oncological safety in male patients with MLRC (In this work, with the updated analysis of urogenital function and follow-up oncological outcomes of the PUF-01 trial, we investigate both function protection and oncological safety of DVF preservation during laparoscopic TME for male rectal cancer patients. The per-protocol analysis reveals that the postoperative urogenital function was better in the L-DVF-P group. The modified intention-to-treat analysis for oncological data reveals no significant differences in 3-year overall survival (OS), 3-year disease-free survival (DFS), and recurrence rate between the two groups. Taking together, L-DVF-P reveals better postoperative urogenital function and comparable oncological outcomes for male rectal cancer patients.