Evidence map›Paper›PMID 29072488›Full record

ArticleThe British journal of radiology2018

T3 subclassification using the EMD/mesorectum ratio predicts neoadjuvant chemoradiation outcome in T3 rectal cancer patients.

Lijun Shen, Yiqun Sun, Hui Zhang, Jing Zhang, Weijuan Deng, Yaqi Wang, Ye Yao, Lifeng Yang, Ji Zhu, Tong Tong and 2 more

Open access · greenAbstract read
In one paragraph

Article in The British journal of radiology, 2018. 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
0.2field-weighted citation impact, top 40% 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

3 citing papers in PubMed, 8 citations in OpenAlex.

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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

12 authors at 2 institutions in 1 country.

Lijun Shen1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Yiqun Sun2 Department of Oncology,Shanghai Medical College, Fudan University , Shanghai Medical College, Fudan University , Shanghai , China.
Hui Zhang1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Jing Zhang1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Weijuan Deng1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Yaqi Wang1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Ye Yao1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Lifeng Yang1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Ji Zhu1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Tong Tong2 Department of Oncology,Shanghai Medical College, Fudan University , Shanghai Medical College, Fudan University , Shanghai , China.
Liping Liang1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Zhen Zhang1 Department of Radiation Oncology,Fudan University Shanghai Cancer Center , Fudan University Shanghai Cancer Center , Shanghai , China.
Fudan University Shanghai Cancer Center · CNShanghai Medical College of Fudan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the feasibility of the EMD (extramural depth)/mesorectum ratio as a marker for T3 rectal cancer and its ability to predict tumour response to neoadjuvant chemoradiation and survival.

methodsFrom 2010 to 2016, 284 T3 rectal cancer patients who underwent high resolution MRI before neoadjuvant chemoradiation were enrolled. The EMD was defined as the distance from the outer edge of the muscularis propria to the outermost edge of the tumour. The measurement of the tumour EMD and mesorectum was in the same layer and their ratio was calculated. Receiver operating characteristic analysis and relative area under the curve statistics were used to choose the cut-off value. The association of the EMD/mesorectum ratio and other MRI or clinical factors with the tumour regression grade (TRG) was analysed. Cox regression analysis was used to estimate independent risk factors for disease-free survival (DFS) and overall survival (OS).

resultsThe mean EMD/mesorectum ratio was 0.47 ± 0.3. We chose an EMD/mesorectum ratio of 0.5 in further analyses after receiver operating characteristic analysis. Of 284 patients, 177 (62.3%) had an EMD/mesorectum ratio ≤ 0.5. Patients with an EMD/mesorectum ratio ≤ 0.5 had a higher TRG 0-1 rate than patients with a ratio >0.5 (53.1% vs 36.4%, p = 0.006). A multivariate analysis identified that an EMD/mesorectum ratio >0.5 [hazard ratio (HR) 2.020; p = 0.028] and ypTNM II-III (HR 3.550; p = 0.017) were independent prognostic factors to indicate decreased DFS. For OS, only patients with TRG 2-3 had decreased OS compared with patients with TRG 0-1 (HR 2.959; p = 0.035).

conclusionWhen the EMD/mesorectum ratio was applied to categorize T3 rectal cancer patients, the ratio of 0.5 can be used as a cut-off value for T3 rectal cancer. Patients with a ratio ≤ 0.5 had a higher response rate and better DFS. However, further validation is needed in a larger sample of patients. Advances in knowledge: The EMD/mesorectum ratio may serve to predict tumour response to neoadjuvant chemoradiation and survival in T3 rectal cancer patients.

Indexed as

Chemoradiotherapy, AdjuvantMagnetic Resonance ImagingAdultAgedAged, 80 and overDisease-Free SurvivalFeasibility StudiesFemaleHumansMaleMiddle AgedNeoadjuvant TherapyNeoplasm InvasivenessRectal NeoplasmsYoung Adult

Identifiers

PMID29072488
PMCPMC5966220
OpenAlexW2766955868

What OpenQuestion holds

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Registered trials

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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.