دورية أكاديمية
أعرض في EDS

Endoscopy and MRI for restaging early rectal cancer after neoadjuvant treatment.

التفاصيل البيبلوغرافية
العنوان: Endoscopy and MRI for restaging early rectal cancer after neoadjuvant treatment.
المؤلفون: Stijns RCH; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., Leijtens J; Department of Surgery, Laurentius Hospital, Roermond, The Netherlands., de Graaf E; Department of Surgery, IJsselland Hospital, Capelle aan de Ijssel, The Netherlands., Bach SP; Department of Surgery, University Hospitals Birmingham, Birmingham, UK., Beets G; Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands., Bremers AJA; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands., Beets-Tan RGH; Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.; GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark., de Wilt JHW; Department of Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands.
المصدر: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2023 Feb; Vol. 25 (2), pp. 211-221. Date of Electronic Publication: 2022 Oct 09.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Blackwell Science Ltd Country of Publication: England NLM ID: 100883611 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1463-1318 (Electronic) Linking ISSN: 14628910 NLM ISO Abbreviation: Colorectal Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford, UK : Blackwell Science Ltd.,
مواضيع طبية MeSH: Neoadjuvant Therapy* , Rectal Neoplasms*/surgery, Humans ; Diffusion Magnetic Resonance Imaging ; Treatment Outcome ; Magnetic Resonance Imaging ; Chemoradiotherapy ; Endoscopy, Gastrointestinal ; Retrospective Studies
مستخلص: Aim: Chemoradiotherapy (CRT) has great potential to downstage rectal cancer. Response assessment has been investigated in locally advanced rectal cancer but not in early stage rectal cancer. The aim is to characterize the diagnostic accuracy of endoscopy performed by surgical endoscopists compared to (diffusion-weighted, DWI) MRI only and a multimodal approach combining (DWI-)MRI and endoscopic information both analysed by an abdominal radiologist for response assessment in early rectal cancer after neoadjuvant CRT.
Materials and Methods: Patients treated with neoadjuvant CRT for early distal rectal cancer (cT1-3 N0) followed by transanal endoscopic microsurgery were included. Three separate reassessment groups were analysed for response assessment using endoscopic evaluation alone versus (DWI-)MRI alone versus the combination of endoscopy with (DWI-)MRI with a focus on sensitivity and specificity and analysis using receiver operating characteristic curves.
Results: Three cohorts (N = 36, N = 25 and N = 25, respectively) were analysed for response assessment. Of the endoscopy cohort, 16 of the 36 patients had a complete response. Area under the curve was 0.69 (0.66-0.74; pooled sensitivity 55.3%, pooled specificity 80.0%). Agreement for scoring separate endoscopic features was poor to moderate. Of the (DWI-)MRI cohort, 11 of the 25 patients had a complete response. Area under the curve for (DWI-)MRI alone was 0.55 (sensitivity 72.7%, specificity 42.9%). The areas under the receiver operating characteristic curve improved to 0.68 (sensitivity 90.9%, specificity 75.0%) when (DWI-)MRI was combined with endoscopic information, with 11 out of 25 patients with a complete response. The most accurate response assessment was made by combining endoscopy and (DWI-)MRI with a high negative predictive value (90.9%).
Conclusion: Good and complete responders after chemoradiation of early stage rectal cancer can be best assessed using a multimodality approach combining endoscopy and (DWI-)MRI.
(© 2022 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
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معلومات مُعتمدة: 28538 United Kingdom CRUK_ Cancer Research UK
فهرسة مساهمة: Keywords: chemoradiotherapy; diffusion-weighted imaging; early rectal cancer; endoscopy; magnetic resonance imaging; response assessment
تواريخ الأحداث: Date Created: 20220914 Date Completed: 20230224 Latest Revision: 20240210
رمز التحديث: 20240210
DOI: 10.1111/codi.16341
PMID: 36104011
قاعدة البيانات: MEDLINE
الوصف
تدمد:1463-1318
DOI:10.1111/codi.16341