Evidence map›Paper›PMID 27698520›Full record

ArticleThe Ulster medical journal2016

Re-Staging Following Long-Course Chemoradiotherapy For Rectal Cancer: Does It Influence Management?

A McBrearty, K McCallion, R J Moorehead, I McAllister, K Mulholland, R Gilliland, W J Campbell

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Article in The Ulster medical journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

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2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

A McBreartyDepartment of General Surgery, Ulster Hospital, Dundonald, Belfast, BT16 1RH.
K McCallionDepartment of General Surgery, Ulster Hospital, Dundonald, Belfast, BT16 1RH.
R J MooreheadDepartment of General Surgery, Ulster Hospital, Dundonald, Belfast, BT16 1RH.
I McAllisterDepartment of General Surgery, Ulster Hospital, Dundonald, Belfast, BT16 1RH.
K MulhollandDepartment of General Surgery, Ulster Hospital, Dundonald, Belfast, BT16 1RH.
R GillilandDepartment of General Surgery, Ulster Hospital, Dundonald, Belfast, BT16 1RH.
W J CampbellDepartment of General Surgery, Ulster Hospital, Dundonald, Belfast, BT16 1RH.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with locally advanced or low rectal cancers, long-course chemoradiotherapy (LCCRT) is recommended prior to surgical management.

methodsA retrospective review of patients with rectal cancer discussed at the South Eastern Health and Social Care Trust Lower Gastrointestinal Multi-Disciplinary Team Meeting (LGIMDT) in 2013 who had received long-course chemoradiotherapy was performed. Patients were identified from the Trust Audit Department, LGIMDT notes and patient records. Imaging results and outcomes from meetings were obtained through the Northern Ireland Picture Archiving and Communications System

resultsSeventy-one patients with rectal cancer were identified as having LCCRT in 2013 (M:F 36:35; age range 31 - 85 years). Fifty-nine patients were restaged following long-course treatment with computed tomography (CT) and magnetic resonance imaging (MRI). Twelve patients did not undergo restaging. Data was not available for 6 patients, one patient underwent emergency surgery, two patients were not fit for treatment, one failed to attend for restaging and two patients died prior to completion of treatment. Of the 59 patients restaged, 19 patients (32%) had their management plan altered from that which had been proposed at the initial LGIMDT discussion. The most common change in plan was not to operate. Ten patients had a complete clinical and radiological response to treatment and have undergone intensive follow-up. Nine patients had disease progression, with 3 requiring palliative surgery and 6 referred for palliative care.

conclusionOf those patients who were restaged, 32% had their management plan altered from that recorded at the initial LGIMDT discussion. Seventeen per cent of patients in this group had a complete clinical and radiological response to treatment. Fifteen percent demonstrated disease progression. We recommend, therefore, that patients with rectal cancer be restaged with CT and MRI following long-course chemoradiotherapy as surgery may be avoided in up to 27% of cases.

Indexed as

Disease ManagementNeoplasm StagingAdenocarcinomaAdultAgedAged, 80 and overChemoradiotherapyFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedRectal NeoplasmsRetrospective StudiesTomography, X-Ray Computed

Identifiers

PMID27698520
PMCPMC5031105

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