Evidence map›Paper›PMID 28991080›Full record

Trial reportDiseases of the colon and rectum2017

Prospective Trial Evaluating the Surgical Anastomosis at One-Year Colorectal Cancer Surveillance: CT Colonography Versus Optical Colonoscopy and Implications for Patient Care.

Perry J Pickhardt, Kristin Edwards, David H Bruining, Marc Gollub, Sonja Kupfer, Sam J Lubner, David H Kim, Eric Ross, Eileen Keenan, David S Weinberg

Abstract readClinical TrialComparative StudyMulticenter Study
In one paragraph

Trial report in Diseases of the colon and rectum, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 30% of its field
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

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Guideline
  2. Trial
  3. Reevaluating the Evidence for Intensive Postoperative Extracolonic Surveillance for Nonmetastatic Colorectal Cancer.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022
    Article
  4. Article
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

10 authors at 5 institutions in 1 country.

Perry J Pickhardt1 University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin 2 Fox Chase Cancer Center, Philadelphia, Pennsylvania 3 Mayo Clinic, Rochester, Minnesota 4 Memorial Sloan-Kettering Cancer Center, New York, New York 5 University of Chicago Medical Center, Chicago, Illinois.
Kristin Edwards
David H Bruining
Marc Gollub
Sonja Kupfer
Sam J Lubner
David H Kim
Eric Ross
Eileen Keenan
David S Weinberg
Fox Chase Cancer Center · USUniversity of Wisconsin–Madison · USMayo Clinic · USMemorial Sloan Kettering Cancer Center · USUniversity of Chicago Medical Center · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
WORD PROCESSING CENTER--COREP30CA006927 · NCI · RESEARCH INST OF FOX CHASE CAN CTR · PI Dietmar J Kappes · 1985 to 2026
$138.8M
Comparative Effectiveness of Virtual and Optical Colonoscopy for CRC SurveillanceR01CA155347 · NCI · RESEARCH INST OF FOX CHASE CAN CTR · PI WEINBERG, DAVID S · 2011 to 2015
$3.3M
NCI NIH HHS P30 CA006927NCI NIH HHS P30 CA008748NCI NIH HHS R01 CA155347
6 · The paper itself

Abstract

objectiveThe aim of this study was to compare the accuracy of CT colonography versus optical colonoscopy for neoplastic involvement at the surgical anastomosis 1 year after curative-intent colorectal cancer resection. DESIGN, SETTING, PATIENTS, AND

interventionsTwo hundred one patients (mean age, 58.6 years; 117 men, 84 women) underwent same-day contrast-enhanced CT colonography and colonoscopy approximately 1 year (mean, 12.1 months; median, 11.9 months) after colorectal cancer resection as part of a prospective, multicenter trial. All patients enrolled were without clinical evidence of disease and considered low risk for recurrence (stage I-III).

main outcome measuresSuspected neoplastic lesions within 5 cm of the colonic anastomosis were recorded at CT colonography, with subsequent colonoscopy performed for the same, with segmental unblinding of colonography findings. Anastomotic region biopsy or polypectomy was performed at the endoscopist's discretion.

resultsNone of the 201 patients had intraluminal anastomotic cancer recurrence or advanced neoplasia (or metachronous cancers). CT colonography detected extramural perianastomotic recurrence in 2 patients (1.0%); neither was detected at colonoscopy. Only 2 patients (1.0%; 2/201) were called positive at CT colonography for intraluminal anastomotic nondiminutive lesions (7- to 8-mm polyps), which were confirmed at colonoscopy but nonneoplastic at histopathology. At optical colonoscopy, the anastomosis was deemed abnormal and/or biopsied in 10.0% (20/201), yielding only 1 nondiminutive benign neoplasm (7-mm tubular adenoma). LIMITATIONS: The lack of luminal cancer recurrence in our lower-risk cohort precludes assessment of sensitivity for detection, rendering the study underpowered in this regard. Potential cost savings of combined CT/CT colonography over the standard CT/colonoscopy approach were not assessed.

conclusionsRelevant intraluminal anastomotic pathology appears to be very uncommon 1 year after colorectal cancer resection in lower-risk cohorts. Unlike colonoscopy, diagnostic contrast-enhanced CT colonography effectively evaluates both the intra- and extraluminal aspects of the anastomosis. See Video Abstract at http://links.lww.com/DCR/A471.

Indexed as

Colonography, Computed TomographicAdenomaAdultAftercareAgedAged, 80 and overAnastomosis, SurgicalColonColonoscopyColorectal NeoplasmsFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm Recurrence, Local

Identifiers

PMID28991080
PMCPMC5635837
OpenAlexW2761922153

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.