Figure 1. (A–D): Neoadjuvant vs. adjuvant chemotherapy meta-analysis outcomes. (A) Recurrence, (B) Five-year overall survival, (C) Five-year disease-free survival, (D) Negative margin (R0) rates.

Figure 1. (A–D): Neoadjuvant vs. adjuvant chemotherapy meta-analysis outcomes. (A) Recurrence, (B) Five-year overall survival, (C) Five-year disease-free survival, (D) Negative margin (R0) rates.

Figure 2. (A–F): Local excision vs. radical excision meta-analysis results. (A) Recurrence, (B) Five-year Overall Survival, (C) Five-year Disease-free Survival, (D) Length of Stay, (E) Intraoperative Tumour Perforation, (F) R0 Rates.

Figure 2. (A–F): Local excision vs. radical excision meta-analysis results. (A) Recurrence, (B) Five-year Overall Survival, (C) Five-year Disease-free Survival, (D) Length of Stay, (E) Intraoperative Tumour Perforation, (F) R0 Rates.

Table 1. Methodological characteristics of the included studies.

Table 1. Methodological characteristics of the included studies.

Study NameJournalYear PublishedStudy PeriodType of StudyN of Rectal GISTs PatientsYong et al. [16]International Journal of Clinical Oncology2021 1996 to 2017Retrospective Cohort Study29Yang et al. [17]BMC Surgery2021 2002 to 2020Retrospective Cohort Study101Qin et al. [18]Annals of Translational Medicine2021 2008 to 2018Retrospective study17Liu et al. [19]Cancer Management and Research2021 2010 to 2019Retrospective Cohort Study21Ling et al. [20]Journal of Surgical Oncology2021 2007 to 2018Retrospective case–control study68 Emoto et al. [21]Journal of Gastrointestinal Surgery2021 2008 to 2017Retrospective Cohort Study20Bai et al. [22]Surgical Endoscopy2021 2006 to 2017Retrospective Cohort Study42Yang et al. [23]Annals of Translational Medicine2020 2008 to 2018Retrospective Cohort Study64Shu et al. [24]International Journal of Surgery2020 2004 to 2017Retrospective Cohort Study71Romain et al. [25]Journal of Surgical Oncology2020 2001 to 2013Retrospective Cohort Study35Ijzerman et al. [26]European Journal of Surgical Oncology2020 2009 to 2018Retrospective, multicentre, international cohort study155 total surgery/ 109 with data analysisGuo et al. [27]International Journal of Surgery2020 2008 to 2019Retrospective Cohort Study64Stuart et al. [28]Journal of Surgical Oncology2019 1976 to 2017Retrospective review48Zhu et al. [29]Journal of Gastrointestinal Oncology2018 2006 to 2013Retrospective Cohort Study282Yasui et al. [30]Surgery Today2017 2003 to 2007Retrospective Cohort Study24Hawkins et al. [31]Annals of Surgical Oncology2017 1998 to 2012Retrospective Cohort Study321Cavnar et al. [32]Annals of Surgical Oncology2017 1982 to 2016Retrospective review47Zanwar et al. [33]Indian Journal of Gastroenterology2016 2005 to 2015Cohort Study18Wilkinson et al. [34] British Journal of Surgery2015 2001 to 2013Retrospective Cohort Study13Shen et al. [35]Neoplasma20152005 to 2014Retrospective Cohort Study45Liu et al. [1]Journal of Surgical Oncology2014 2002 to 2010Retrospective review21Huynh et al. [36]BMC Cancer2014 1991 to 2011Retrospective Cohort Study41Xiao et al. [37]Journal of Gastrointestinal Surgery2013 1986 to 2010Retrospective Cohort Study21Tielen et al. [5]Journal of Surgical Oncology2013 1990 to 2011Retrospective Cohort Study32Agaimy et al. [38]International Journal of Colorectal Disease2013 2000 and 2011Retrospective multicentre study15Dong et al. [39]Scandinavian Journal of Gastroenterology2007 1997 to 2005Retrospective Cohort Study29Hassan et al. [40]Diseases of the Colon and Rectum2006 1979 to 2004Retrospective Cohort Study14Changchien et al. [41]Diseases of the Colon and Rectum2004 1979 to 1999Retrospective Cohort Study42

Table 2. Summary of Surgical Detail.

Table 2. Summary of Surgical Detail.

Study NameTotal N PatientsTumour Size at Diagnosis (cm)-Mean Local ExcisionRadical ExcisionSurgical ApproachMargin StatusR0/%R1/%R2/%Yong et al. [16]29--29Transanal 7/29
Laparoscopic 2/29
Open 20/2915 of 29/51.7%10 of 29/34.5%-Yang et al. [17]1016.18 ± 3.02956Transanal 5/101
Laparoscopic 14/101
Open 82/10197 of 101/96%4 of 101/4%Qin et al. [18]176.4 ± 2.2-17-17 of 17/100%0 of 17/0%Liu et al. [19]214.96 ± 3.02156-16 of 21/76.2%5 of 21/23.8%-Ling et al. [20]68 -5014--Emoto et al. [21]206.5 ± 3416Transanal 4/20
Laparoscopic 15/20
Open 1/2017 of 20/85%3 of 20/15%Bai et al. [22]422.87 ± 1.6142-Transanal 42/42
Laparoscopic 0/42
Open 0/4242 of 42/100%0 of 42/0%Yang et al. [23]64-2935Transanal 29/64
Laparoscopic N/a
Open N/a
Nontransanal 35/6463 of 64/98.4%1 of 64/1.6%Shu et al. [24]71-4229-56 of 71/78.9%15 of 71/21.2%0 of 71/0%Romain et al. [25]35-35Transanal 9/35
Laparoscopic 3/35
Open 23/3530 of 35/85.7%4 of 35/11.4%1 of 35/2.9%Ijzerman et al. [26]1096.5 ± 3.674663-67 of 109/61.5%31 of 109/28.4%10 of 109/9.2%Guo et al. [27]64-39 25 -63 of 64/98.4%1 of 64/1.6%Stuart et al. [28]48-48--Zhu et al. [29]282-144138-219 of 282/77.7%3 of 282/1.1%Yasui et al. [30]244.8 ± 2.38914Transanal 1/24
Laparoscopic 0/24
Open 23/2422 of 24/91.7%1 of 24/4.2%1 of 24/4.2%Hawkins et al. [31]3214.0 ± 0.8163158 -247 of 321/76.9%74 of 321/23.1%Cavnar et al. [32]47-2324-33 of 47/70.2%12 of 47/25.5%2 of 47/4.3%Zanwar et al. [33]186 ± 2.45414 -17 of 18/94.4%0 of 18/0%1 of 18/5.6%Wilkinson et al. [34] 137⋅6 ± 2.613-12 of 13/92.3%0 of 13/0%1 of 13/7.7%Shen et al. [35]456.0 ± 32124-43 of 45/95.6%2 of 45/4.4%0 of 45/0%Liu et al. [1]216.53 ± 2.45138-17 of 21/81%4 of 21/19%Huynh et al. [36]416.3 ± 3.11823-22 of 41/53.7%13 of 41/31.7%4 of 41/9.8%Xiao et al. [37]217.5 ± 6.41011-21 of 21/100%0 of 21/0%Tielen et al. [5]329.2 ± 12.75725Transanal 2/32
Laparoscopic N/a
Open N/a
Nontransanal 30/3224 of 32/75%6 of 32/18.8%2 of 32/6.3%Agaimy et al. [38]154.8 ± 2.1778-6 of 15/40%2 of 15/13.3%6 of 15/40%Dong et al. [39]295.0 ± 4.41415Transanal 14/29
Laparoscopic 0/29
Open 15/2929 of 29/100%0 of 29/0%Hassan et al. [40]14-59Transanal 4/14
Laparoscopic 0/14
Open 10/1414 of 14/100%0 of 14/0%Changchien et al. [41]42-1329--

Table 3. Summary of Chemotherapy Details.

Table 3. Summary of Chemotherapy Details.

Study NameNeo-Adjuvant TherapyAdjuvant Therapy No. Patients TypeDuration (Median (Month)) (Range)No. Patients TypeDuration (Median (Month)) (Range)Yong et al. [16]11/36Imatinib8.8 (4.5–33.9)---Yang et al. [17]31/101Imatinib-49/101Imatinib-Qin et al. [18]15/17Imatinib-14/17Imatinib1 (1–8)Liu et al. [19]21/36Imatinib17 10/21Imatinib17 Ling et al. [20]52/85Imatinib6.9 (1.0–58.9)40/68Imatinib-Emoto et al. [21]16/20Imatinib7 (4–11)11/20Imatinib35 (11–108)Bai et al. [22]16/42Imatinib6 15/42Imatinib18 (7–36)Yang et al. [23]29/64Imatinib-30/64Imatinib-Shu et al. [24]23/71Imatinib7.0 (6–12)21/71Imatinib-Romain et al. [25]22/35Imatinib9 (4–14)21/35Imatinib-Ijzerman et al. [26]78/109Imatinib10 (1–102),70/109Imatinib25 (0–112).Guo et al. [27]29/64Imatinib-30/64Imatinib-Stuart et al. [28]8/48Imatinib-22/48Imatinib-Zhu et al. [29]------Yasui et al. [30]4/24 2.5 (1–6)3/24Imatinib-Hawkins et al. [31]86/321Imatinib-82/321Imatinib-Cavnar et al. [32]21/47Imatinib7.7 (3–62) 2212/47Imatinib2.8 (0.1–6.5)Zanwar et al. [33]16/23Imatinib15 (3–84)---Wilkinson et al. [34] 15/19Imatinib18 (11–44)7/19Imatinib-Shen et al. [35]3/45Imatinib-13/45Imatinib18 (3–46).Liu et al. [1]5/21Imatinib6 (6–8)8/21Imatinib-Huynh et al. [36]12/41Imatinib7 (2–12).11/41Imatinib7 (2–41)Xiao et al. [37]-Imatinib-4/21Imatinib -Tielen et al. [5]22/32Imatinib9 (2–53)9/32Imatinib-Agaimy et al. [38]4/15Imatinib (2/4)Sunitinib (1/4)Adriamycin + Holoxan (1/4)-9/15Imatinib-Dong et al. [39]------Hassan et al. [40]------Changchien et al. [41] -----