Modest agreement between magnetic resonance and pathological tumor regression after neoadjuvant therapy for rectal cancer in the real world.

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State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_6039E6222FA7
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Modest agreement between magnetic resonance and pathological tumor regression after neoadjuvant therapy for rectal cancer in the real world.
Journal
International journal of cancer
Author(s)
Achilli P., Magistro C., Abd El Aziz M.A., Calini G., Bertoglio C.L., Ferrari G., Mari G., Maggioni D., Peros G., Tamburello S., Coppola E., Spinelli A., Grass F., Martin D., Hahnloser D., Salvatori A., De Simoni S., Sheedy S.P., Fletcher J.G., Larson D.W.
ISSN
1097-0215 (Electronic)
ISSN-L
0020-7136
Publication state
Published
Issued date
01/07/2022
Peer-reviewed
Oui
Volume
151
Number
1
Pages
120-127
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
Magnetic resonance imaging (MRI) is routinely used for preoperative tumor staging and to assess response to therapy in rectal cancer patients. The aim of our study was to evaluate the accuracy of MRI based restaging after neoadjuvant chemoradiotherapy (CRT) in predicting pathologic response. This multicenter cohort study included adult patients with histologically confirmed locally advanced rectal adenocarcinoma treated with neoadjuvant CRT followed by curative intent elective surgery between January 2014 and December 2019 at four academic high-volume institutions. Magnetic resonance tumor regression grade (mrTRG) and pathologic tumor regression grade (pTRG) were reviewed and compared for all the patients. The agreement between radiologist and pathologist was assessed with the weighted k test. Risk factors for poor agreement were investigated using logistic regression. A total of 309 patients were included. Modest agreement was found between mrTRG and pTRG when regression was classified according to standard five-tier systems (k = 0.386). When only two categories were considered for each regression system, (pTRG 0-3 vs pTRG 4; mrTRG 2-5 vs mrTRG 1) an accuracy of 78% (95% confidence interval [CI] 0.73-0.83) was found between radiologic and pathologic assessment with a k value of 0.185. The logistic regression model revealed that "T3 greater than 5 mm extent" was the only variable significantly impacting on disagreement (OR 0.33, 95% CI 0.15-0.68, P = .0034). Modest agreement exists between mrTRG and pTRG. The chances of appropriate assessment of the regression grade after neoadjuvant CRT appear to be higher in case of a T3 tumor with at least 5 mm extension in the mesorectal fat at the pretreatment MRI.
Keywords
Adult, Chemoradiotherapy/methods, Cohort Studies, Humans, Magnetic Resonance Imaging/methods, Magnetic Resonance Spectroscopy, Neoadjuvant Therapy/methods, Neoplasm Staging, Rare Diseases/pathology, Rectal Neoplasms/drug therapy, Rectal Neoplasms/therapy, Retrospective Studies, Treatment Outcome, agreement analysis, magnetic resonance, neoadjuvant therapy, rectal cancer, tumor regression grade
Pubmed
Web of science
Open Access
Yes
Create date
28/02/2022 10:40
Last modification date
28/05/2022 6:34
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