Evidence map›Paper›PMID 28890811›Full record

ArticleJournal of gastrointestinal oncology2017

Tumor stage in patients operated for rectal cancer: a comparison of the pre-operative MR and the resection specimen, with specific attention to the effect of neo-adjuvant radiotherapy.

Elmer E van Eeghen, Sandra D Bakker, Gerwin Fransen, Marcel J Flens, Ruud J L F Loffeld

Abstract read
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Article in Journal of gastrointestinal oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

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

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Elmer E van EeghenDepartment of Internal Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands.
Sandra D BakkerDepartment of Internal Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands.
Gerwin FransenDepartment of Radiology, Zaans Medisch Centrum, Zaandam, The Netherlands.
Marcel J FlensDepartment of Pathology, Free University Hospital, Amsterdam, The Netherlands.
Ruud J L F LoffeldDepartment of Internal Medicine, Zaans Medisch Centrum, Zaandam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvaluate the preoperative TN stage with MR and the postoperative stage with histology.

methodsPatients diagnosed with rectal cancer (2002-2015) and a pre-operative MR were included. A chart review was done. Pathology reports were evaluated for the post-operative tumor stage. Down staging was defined as a lower disease stage in the resection specimen compared with the pre-operative MR. Upgrading ("progression") was defined as a higher disease stage in the resection specimen. The study was approved by ethical committee of the Zaans Medisch Centrum.

resultsFrom 176 out of 231 operated patients a pre-operative MR was available for evaluation. 142 patients (80.7%) underwent neo-adjuvant treatment; the remainder 19.3% underwent immediate surgery. Neo-adjuvant therapy resulted in significant down staging. However, almost 14% of patients had a higher TN stage as determined by the pre-operative MR. In patients who underwent immediate surgery the percentage with "progression" was 30%. The number of patients with stage 1 and 2 were higher in the group not treated with neo-adjuvant therapy. There was no significant difference in tumor stage as determined by histological examination of the resection specimen.

conclusionsThe diagnostic accuracy of the MR is not perfect. Underestimation as well as overestimation of the tumor occurred both in the patients treated with radiotherapy as well as those who underwent immediate operation. As such, MR results should be interpreted with caution when devising a treatment strategy.

Indexed as

down-staginggold standardhistologyMRI-stagingRectal cancer

Identifiers

PMID28890811
PMCPMC5582031

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