The role of MRI after neochemoradiotherapy in predicting pathological tumor regression grade and clinical outcome in patients with locally advanced rectal adenocarcinoma Article Swipe
Shaoqing Niu
,
Yan Chen
,
Peng Fang
,
Jie Wen
,
Jianqi Xiong
,
Zhuangzhuang Yang
,
Jianjun Peng
,
Yong Bao
,
Ding Li
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fonc.2023.1118518
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.3389/fonc.2023.1118518
Objective To evaluate the predictive value of tumor regression grade assessed by MRI (mr-TRG) after neoadjuvant chemoradiotherapy (neo-CRT) for postoperative pathological TRG (pTRG) and prognosis in patients with locally advanced rectal adenocarcinoma (LARC). Materials and methods This was a retrospective study from a single center experience. The patients who were diagnosed with LARC and received neo-CRT in our department between January 2016 and July 2021 were enrolled. The agreement between mrTRG and pTRG was assessed with the weighted κ test. Overall survival (OS), progress-free survival (PFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) were calculated by Kaplan-Meier analysis and log-rank test. Results From January 2016 to July 2021, 121 LARC patients received neo-CRT in our department. Among them, 54 patients had complete clinical data, including MRI of pre- and post-neo-CRT, postoperative tumor samples, and follow-up. The median follow-up time was 34.6 months (range: 4.4-70.6 months). The estimated 3-year OS, PFS, LRFS and DMFS were 78.5%, 70.7%, 89.0%, and 75.2%, respectively. The median time from the completion of neo-CRT to preoperative MRI and surgery was 7.1 weeks and 9.7 weeks, respectively. Out of 54 patients, 5 patients achieved mrTRG1 (9.3%), 37 achieved mrTRG2 (68.5%), 8 achieved mrTRG3 (14.8%), 4 achieved mrTRG4 (7.4%), and no patient achieved mrTRG5 after neo-CRT. Regarding pTRG, 12 patients achieved pTRG0 (22.2%), 10 achieved pTRG1 (18.5%), 26 achieved pTRG2 (48.1%), and 6 achieved pTRG3 (11.1%). The agreement between three-tier mrTRG (mrTRG1 vs. mrTRG2-3 vs. mrTRG4-5) and pTRG (pTRG0 vs. pTRG1-2 vs. pTRG3) was fair (weighted kappa=0.287). In a dichotomous classification, the agreement between mrTRG(mrTRG1 vs. mrTRG2-5)and pTRG(pTRG0 vs. pTRG1-3) also resulted in fair agreement (weighted kappa=0.391). The sensitivity, specificity, positive, and negative predictive values of favorable mrTRG (mrTRG 1-2) for pathological complete response (PCR) were 75.0%, 21.4%, 21.4%, and 75.0%, respectively. In univariate analysis, favorable mrTRG (mrTRG1-2) and downstaging N were significantly associated with better OS, while favorable mrTRG (mrTRG1-2), downstaging T, and downstaging N were significantly associated with superior PFS ( p <0.05). In multivariate analysis, downstaging N was an independent prognostic factor for OS. Meanwhile, downstaging T and downstaging N remained independent prognostic factors for PFS. Conclusions Although the consistency between mrTRG and pTRG is only fair, favorable mrTRG after neo-CRT may be used as a potential prognostic factor for LARC patients.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fonc.2023.1118518
- OA Status
- gold
- Cited By
- 5
- References
- 33
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4380366345
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4380366345Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.3389/fonc.2023.1118518Digital Object Identifier
- Title
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The role of MRI after neochemoradiotherapy in predicting pathological tumor regression grade and clinical outcome in patients with locally advanced rectal adenocarcinomaWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2023Year of publication
- Publication date
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2023-06-12Full publication date if available
- Authors
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Shaoqing Niu, Yan Chen, Peng Fang, Jie Wen, Jianqi Xiong, Zhuangzhuang Yang, Jianjun Peng, Yong Bao, Ding LiList of authors in order
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https://doi.org/10.3389/fonc.2023.1118518Publisher landing page
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
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https://doi.org/10.3389/fonc.2023.1118518Direct OA link when available
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Medicine, Colorectal cancer, Pathological, Retrospective cohort study, Adenocarcinoma, Chemoradiotherapy, Internal medicine, Single Center, Proportional hazards model, Overall survival, Surgery, Radiology, CancerTop concepts (fields/topics) attached by OpenAlex
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5Total citation count in OpenAlex
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2025: 1, 2024: 3, 2023: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.three-tier | 233 |
| abstract_inverted_index.univariate | 297 |
| abstract_inverted_index.(mrTRG1-2), | 314 |
| abstract_inverted_index.Conclusions | 353 |
| abstract_inverted_index.consistency | 356 |
| abstract_inverted_index.department. | 117 |
| abstract_inverted_index.dichotomous | 253 |
| abstract_inverted_index.downstaging | 303, 315, 318, 332, 342, 345 |
| abstract_inverted_index.experience. | 45 |
| abstract_inverted_index.independent | 336, 348 |
| abstract_inverted_index.neoadjuvant | 15 |
| abstract_inverted_index.Kaplan-Meier | 98 |
| abstract_inverted_index.mrTRG(mrTRG1 | 258 |
| abstract_inverted_index.mrTRG2-5)and | 260 |
| abstract_inverted_index.multivariate | 330 |
| abstract_inverted_index.pathological | 20, 285 |
| abstract_inverted_index.preoperative | 171 |
| abstract_inverted_index.sensitivity, | 272 |
| abstract_inverted_index.specificity, | 273 |
| abstract_inverted_index.kappa=0.287). | 250 |
| abstract_inverted_index.kappa=0.391). | 270 |
| abstract_inverted_index.post-neo-CRT, | 131 |
| abstract_inverted_index.postoperative | 19, 132 |
| abstract_inverted_index.progress-free | 83 |
| abstract_inverted_index.respectively. | 161, 181, 295 |
| abstract_inverted_index.retrospective | 39 |
| abstract_inverted_index.significantly | 306, 321 |
| abstract_inverted_index.&lt;0.05). | 328 |
| abstract_inverted_index.adenocarcinoma | 31 |
| abstract_inverted_index.classification, | 254 |
| abstract_inverted_index.metastasis-free | 92 |
| abstract_inverted_index.recurrence-free | 87 |
| abstract_inverted_index.chemoradiotherapy | 16 |
| cited_by_percentile_year.max | 97 |
| cited_by_percentile_year.min | 89 |
| corresponding_author_ids | https://openalex.org/A5101925317, https://openalex.org/A5050593912 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 9 |
| corresponding_institution_ids | https://openalex.org/I157773358, https://openalex.org/I4210128921 |
| sustainable_development_goals[0].id | https://metadata.un.org/sdg/3 |
| sustainable_development_goals[0].score | 0.5299999713897705 |
| sustainable_development_goals[0].display_name | Good health and well-being |
| citation_normalized_percentile.value | 0.83642292 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |