دورية أكاديمية
Split scar sign to predict complete response in rectal cancer after neoadjuvant chemoradiotherapy: systematic review and meta-analysis.
العنوان: | Split scar sign to predict complete response in rectal cancer after neoadjuvant chemoradiotherapy: systematic review and meta-analysis. |
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المؤلفون: | Torri GB; Department of Radiology and Diagnostic Imaging, University Hospital of Santa Maria, Federal University of Santa Maria, Santa Maria, Rio Grande Do Sul, 97105-900, Brazil., Wiethan CP; Department of Radiology and Diagnostic Imaging, University Hospital of Santa Maria, Federal University of Santa Maria, Santa Maria, Rio Grande Do Sul, 97105-900, Brazil., Langer FW; Department of Radiology and Diagnostic Imaging, University Hospital of Santa Maria, Federal University of Santa Maria, Santa Maria, Rio Grande Do Sul, 97105-900, Brazil., de Oliveira GS; Clinics Hospital of Porto Alegre, R. Ramiro Barcelos, Porto Alegre, 235090035903, Brazil., Meirelles AVB; Clinics Hospital, Federal University of Minas Gerais, Av. Prof. Alfredo Balena, 110 - Santa Efigênia, Belo Horizonte, 30130-100, Brazil., Horvat N; Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA., Tse JR; Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305-5105, USA., Dias AB; Department of Medical Imaging, University of Toronto, 263 McCaul Street, 4Th Floor, Toronto, ON, M5T 1W7, Canada., Altmayer S; Department of Radiology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305-5105, USA. altmayer@stanford.edu. |
المصدر: | European radiology [Eur Radiol] 2024 Jun; Vol. 34 (6), pp. 3874-3881. Date of Electronic Publication: 2023 Nov 18. |
نوع المنشور: | Journal Article; Systematic Review; Meta-Analysis |
اللغة: | English |
بيانات الدورية: | Publisher: Springer International Country of Publication: Germany NLM ID: 9114774 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1084 (Electronic) Linking ISSN: 09387994 NLM ISO Abbreviation: Eur Radiol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Berlin : Springer International, c1991- |
مواضيع طبية MeSH: | Rectal Neoplasms*/therapy , Rectal Neoplasms*/diagnostic imaging , Rectal Neoplasms*/pathology , Neoadjuvant Therapy*/methods , Magnetic Resonance Imaging*/methods, Humans ; Cicatrix/diagnostic imaging ; Chemoradiotherapy/methods ; Sensitivity and Specificity ; Treatment Outcome |
مستخلص: | Objectives: Magnetic resonance imaging (MRI) is the modality of choice for rectal cancer initial staging and restaging after neoadjuvant chemoradiation. Our objective was to perform a meta-analysis of the diagnostic performance of the split scar sign (SSS) on rectal MRI in predicting complete response after neoadjuvant therapy. Methods: MEDLINE, EMBASE, and Cochrane databases were searched for relevant published studies through June 2023. Primary studies met eligibility criteria if they evaluated the diagnostic performance of the SSS to predict complete response on pathology or clinical follow-up in patients undergoing neoadjuvant chemoradiation. A meta-analysis with a random-effects model was used to estimate pooled sensitivity and specificity, area under the curve (AUC), and diagnostic odds ratio (DOR) of the SSS. Results: A total of 4 studies comprising 377 patients met the inclusion criteria. The prevalence of complete response in the studies was 21.7-52.5%. The pooled sensitivity and specificity of the SSS to predict complete response were 62.0% (95% CI, 43.5-78.5%) and 91.9% (95% CI, 78.9-97.2%), respectively. The estimated AUC for SSS was 0.83 (95% CI, 0.56-0.94) with a DOR of 18.8 (95% CI, 3.65-96.5). Conclusion: The presence of SSS on rectal MRI demonstrated high specificity for complete response in patients with rectal cancer after neoadjuvant chemoradiation. This imaging pattern can be a valuable tool to identify potential candidates for organ-sparing treatment and surveillance. Clinical Relevance Statement: SSS presents high specificity for complete response post-neoadjuvant. This MRI finding enhances rectal cancer treatment assessment and aids clinicians and patients in choosing watch-and-wait over immediate surgery, which can potentially reduce costs and associated morbidity. Key Points: •Fifteen to 50% of rectal cancer patients achieve complete response after neoadjuvant chemoradiation and may be eligible for a watch-and-wait strategy. •The split scar sign has high specificity for a complete response. •This imaging finding is valuable to select candidates for organ-sparing management. (© 2024. The Author(s).) |
التعليقات: | Comment in: Eur Radiol. 2024 Jun;34(6):3872-3873. doi: 10.1007/s00330-023-10537-y. (PMID: 38133679) Erratum in: Eur Radiol. 2024 Aug;34(8):5501. doi: 10.1007/s00330-023-10576-5. (PMID: 38240808) |
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معلومات مُعتمدة: | P30 CA008748 United States CA NCI NIH HHS |
فهرسة مساهمة: | Keywords: Magnetic resonance imaging; Rectal neoplasms; Split scar sign; Watchful waiting |
تواريخ الأحداث: | Date Created: 20231118 Date Completed: 20240611 Latest Revision: 20240731 |
رمز التحديث: | 20240731 |
مُعرف محوري في PubMed: | PMC11166750 |
DOI: | 10.1007/s00330-023-10447-z |
PMID: | 37979009 |
قاعدة البيانات: | MEDLINE |
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