MR tumor regression grade for pathological complete response in rectal cancer post neoadjuvant chemoradiotherapy: a systematic review and meta-analysis for accuracy

ConclusionsmrTRG 1 showed high specificity for pCR and ≤ypT1, but suboptimal sensitivity. mrTRG 1 or 2 showed higher sensitivity for pCR and ≤ypT1, but lower specificity. Because of the suboptimal sensitivity of mrTRG 1, it might be limited as a criterion for less aggressive treatment after neoadjuvant chemoradiotherapy.Key Points• Magnetic resonance tumor regression grade 1 shows high specificity for pCR and ≤ypT1, but suboptimal sensitivity.• Magnetic resonance tumor regression grade 1 or 2 shows higher sensitivity for pCR and ≤ypT1, but lower specificity than magnetic resonance tumor regression grade 1 alone.
Source: European Radiology - Category: Radiology Source Type: research

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Abstract During the last two decades a neoadjuvant treatment concept has been established for an increasing number of malignant tumors of the gastrointestinal tract; however, these concepts are still subject to a constant change concerning the indications and type of treatment. A prime example for this is rectal cancer. The rate of local recurrence in particular was significantly reduced by neoadjuvant therapy but until now it has not been possible to validly show an improvement in overall or disease-free survival. At the beginning of the millennium it was recommended to treat every rectal carcinoma...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research
AbstractPurpose of ReviewContrarily to what happens with rectal cancer, the role of magnetic resonance imaging (MRI) in the assessment of colon cancer has been limited. However, we may witness a ‘paradigm shift’ in the future. Classically, colon cancer has been assessed by computed tomography (CT) which is considered the workhorse for evaluating this neoplasm as it provides insights not only about local and regional disease as well as about distant metastases. However, as the accuracy o f CT is somewhat limited, recent reports about the use of MRI in colon cancers have been published. In this review we will ass...
Source: Current Colorectal Cancer Reports - Category: Cancer & Oncology Source Type: research
ConclusionCRT should be considered for cT3N0 patients, but its timing (neoadjuvant vs. adjuvant) seems not to affect the disease-free survival in the present cohort of patients.
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
ConclusionAside from one reader demonstrating increased sensitivity, no significant difference in accuracy parameters or inter-observer agreement was found between MR using b800 and b1500 for the detection of residual tumor after neoadjuvant CRT for LARC. However, there was a suggestion of a trend towards increased sensitivity with b1500, and further studies using larger cohorts may be needed to further investigate this topic.
Source: Abdominal Imaging - Category: Radiology Source Type: research
Abstract Thirty per cent of all colorectal tumours develop in the rectum. The location of the rectum within the bony pelvis and its proximity to vital structures presents significant therapeutic challenges when considering neoadjuvant options and surgical interventions. Most patients with early rectal cancer can be adequately managed by surgery alone. However, a significant proportion of patients with rectal cancer present with locally advanced disease and will potentially benefit from down staging prior to surgery. Neoadjuvant therapy involves a variety of options including radiotherapy, chemotherapy used alone o...
Source: World Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
Yikan Cheng1†, Yan Ma1†, Jian Zheng1†, Hua Deng2†, Xueqin Wang3,4, Yewei Li3,4, Xiaolin Pang1, Haiyang Chen1, Fang He1, Lei Wang5*, Jianping Wang5* and Xiangbo Wan1* 1Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Department of Radiation Oncology, Guangdong Institute of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China 2Department of Radiation Oncology, Banner-University Medical Center Phoenix, Phoenix, AZ, United States 3Department of Statistical Science, Southern China Center for Statistical Science, School of Mathe...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsAdvances in the neoadjuvant treatment of rectal tumors contributed to better rates of complete pathological responses. New paradigms promote an increase in the complete clinical response rates, which would allow organ preservation and consequent reduction of surgical morbidity.ResumoObjetivoDescrever os resultados parciais de estudo em pacientes com câncer de reto submetidos a tratamento neoadjuvante com quimioterapia e radioterapia quanto à taxa resposta clínica completa, sobrevida livre de doença, função anorretal e qualidade de vida.Material e métodosEstudo pros...
Source: Journal of Coloproctology - Category: Gastroenterology Source Type: research
This study evaluated the accuracy and external validity of a recently published morphometric score to predict surgical difficulty and, additionally, proposes a new score to identify preoperatively LARC patients with a high risk of having a difficult surgery.MethodsThis is a retrospective study based on theEuropean MRI and Rectal Cancer Surgery (EuMaRCS) database, including patients with mid/low LARC who were treated with neoadjuvant chemoradiation therapy and laparoscopic total mesorectal excision (L ‐TME) with primary anastomosis. For all patients, pretreatment and restaging magnetic resonance imaging (MRI) were availab...
Source: Colorectal Disease - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Conclusion: The ability of different MRI sequences and magnetic intensities to identify pCR will be evaluated and the best one to diagnose pCR of rectal cancer after therapy will be recommended. Ethics and dissemination: Ethics approval and patient consent are not required, as this study is a meta-analysis based on published studies. PROSPERO registration number: CRD42018105672.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research
ConclusionPre-operative MRI in cancer rectum is irreplaceable to assess initial staging and post-neoadjuvant therapy response thus improving surgical results.
Source: Alexandria Journal of Medicine - Category: General Medicine Source Type: research
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