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dc.contributor.authorSclafani, F
dc.contributor.authorBrown, G
dc.contributor.authorCunningham, D
dc.contributor.authorWotherspoon, A
dc.contributor.authorMendes, LST
dc.contributor.authorBalyasnikova, S
dc.contributor.authorEvans, J
dc.contributor.authorPeckitt, C
dc.contributor.authorBegum, R
dc.contributor.authorTait, D
dc.contributor.authorTabernero, J
dc.contributor.authorGlimelius, B
dc.contributor.authorRoselló, S
dc.contributor.authorThomas, J
dc.contributor.authorOates, J
dc.contributor.authorChau, I
dc.date.accessioned2017-10-24T09:57:23Z
dc.date.issued2017-11
dc.identifier.citationBritish journal of cancer, 2017, 117 (10), pp. 1478 - 1485
dc.identifier.issn0007-0920
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/860
dc.identifier.eissn1532-1827
dc.identifier.doi10.1038/bjc.2017.320
dc.description.abstractBackground Limited data exist regarding the correlation between MRI tumour regression grade (mrTRG) and pathological TRG (pTRG) in rectal cancer.Methods mrTRG and pTRG were compared in rectal cancer patients from two phase II trials (EXPERT and EXPERT-C). The agreement between radiologist and pathologist was assessed with the weighted κ test while the Kaplan-Meier method was used to estimate survival outcomes.Results One hundred ninety-one patients were included. Median time from completion of neoadjuvant treatment to pre-operative MRI and surgery was 4.1 weeks (interquartile range (IQR): 3.7-4.7) and 6.6 weeks (IQR: 5.9-7.6), respectively. Fair agreement was found between mrTRG and pTRG when regression was classified according to standard five-tier systems (κ=0.24) or modified three-tier systems (κ=0.25). Sensitivity and specificity of mrTRG 1-2 (complete/good radiological regression) for the prediction of pathological complete response was 74.4% (95% CI: 58.8-86.5) and 62.8% (95% CI: 54.5-70.6), respectively. Survival outcomes of patients with intermediate pathological regression (pTRG 2) were numerically better if complete/good regression was also observed on imaging (mrTRG 1-2) compared to poor regression (mrTRG 3-5) (5-year recurrence-free survival 76.9% vs 65.9%, P=0.18; 5-year overall survival 80.6% vs 68.8%, P=0.22).Conclusions The agreement between mrTRG and pTRG is low and mrTRG cannot be used as a surrogate of pTRG. Further studies are warranted to assess the ability of mrTRG to identify pathological complete responders for the adoption of non-operative management strategies and to provide complementary prognostic information to pTRG for better risk-stratification after surgery.
dc.formatPrint-Electronic
dc.format.extent1478 - 1485
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://www.rioxx.net/licenses/all-rights-reserved
dc.subjectHumans
dc.subjectRectal Neoplasms
dc.subjectMagnetic Resonance Imaging
dc.subjectNeoplasm Staging
dc.subjectCytodiagnosis
dc.subjectDisease-Free Survival
dc.subjectNeoadjuvant Therapy
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectClinical Trials, Phase II as Topic
dc.subjectKaplan-Meier Estimate
dc.subjectChemoradiotherapy, Adjuvant
dc.titleComparison between MRI and pathology in the assessment of tumour regression grade in rectal cancer.
dc.typeJournal Article
dcterms.dateAccepted2017-08-22
rioxxterms.versionofrecord10.1038/bjc.2017.320
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-sa/4.0
rioxxterms.licenseref.startdate2017-11
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBritish journal of cancer
pubs.issue10
pubs.notes12 months
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Clinical Studies/Medicine (RMH Smith Cunningham)/Medicine (RMH Smith Cunningham) (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.publication-statusPublished
pubs.volume117
pubs.embargo.terms12 months
icr.researchteamMedicine (RMH Smith Cunningham)en_US
dc.contributor.icrauthorCunningham, Daviden
dc.contributor.icrauthorChau, Ianen
dc.contributor.icrauthorMarsden,en


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