Trial reportJAMA oncology2019
Safety and Feasibility of Using Magnetic Resonance Imaging Criteria to Identify Patients With "Good Prognosis" Rectal Cancer Eligible for Primary Surgery: The Phase 2 Nonrandomized QuickSilver Clinical Trial.
Trial report in JAMA oncology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
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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.
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.
Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of radiotherapy for local control in T3N0 rectal cancer managed with total mesorectal excision: a meta-analysis.Oncotarget · 2022Pooled it
- Two-Year Outcomes after Direct-to-Surgery in Good Prognosis Margin-Clear Stage II or III Rectal Cancer: The QuickSilver Study.Annals of surgical oncology · 2026Trial
- Trial
- A Consensus Approach to the Incorporation of Total Neoadjuvant Therapy in a Treatment Algorithm for Stage I-III Resectable Rectal Cancer.Current oncology (Toronto, Ont.) · 2026Review
- Endorectal Ultrasound Versus MRI for Lower and Middle Rectal Cancer Staging in Upfront Surgery: A Comparative Study.Journal of clinical medicine · 2026Article
- Upfront surgery versus preoperative chemoradiotherapy: a comparative survival analysis for stage II/III resectable rectal cancer.Annals of coloproctology · 2026Article
- The Avocado Sign: A novel imaging marker for nodal staging in rectal cancer.European radiology · 2025Article
- A Review on the Evolving Role of Radiation Therapy in the Treatment of Locally Advanced Rectal Cancer.Current oncology (Toronto, Ont.) · 2025Review
- The Landmark Series: Neoadjuvant Therapy for Locally Advanced Rectal Cancer.Annals of surgical oncology · 2025Review
- Early-Onset Colorectal Cancer: From Genetic Discovery to Clinical Innovation.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2025Review
- MRI for Rectal Cancer: Updates and Controversies-AJR. American journal of roentgenology · 2025Review
- Neoadjuvant Radiotherapy vs Up-Front Surgery for Resectable Locally Advanced Rectal Cancer.JAMA network open · 2025Article
- Article
- Article
- Accuracy of Baseline Magnetic Resonance Imaging for Staging Rectal Cancer Patients Proceeding Directly to Surgery.Journal of surgical oncology · 2024Article
- Rectal Cancer and Lateral Lymph Node Staging: Interobserver Agreement and Success in Predicting Locoregional Recurrence.Diagnostics (Basel, Switzerland) · 2024Article
- Omission of Radiotherapy for Locally Advanced Rectal Cancer: A Step Toward Patient-Centric Treatment Decision-Making.Annals of surgical oncology · 2024Article
- The Role of Predictive and Prognostic MRI-Based Biomarkers in the Era of Total Neoadjuvant Treatment in Rectal Cancer.Cancers · 2024Review
- Assessing neoadjuvant therapy recommendations in 19 national and international guidelines for rectal cancer.Techniques in coloproctology · 2024Review
- The role of rectal magnetic resonance imaging in accurate localization and designation of colorectal cancer for optimal management: Case study.Radiology case reports · 2024Article
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Authors and funding
38 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceChemoradiotherapy (CRT), followed by surgery, is the recommended approach for stage II and III rectal cancer. While CRT decreases the risk of local recurrence, it does not improve survival and leads to poorer functional outcomes than surgery alone. Therefore, new approaches to better select patients for CRT are important.
objectiveTo conduct a phase 2 study to evaluate the safety and feasibility of using magnetic resonance imaging (MRI) criteria to select patients with "good prognosis" rectal tumors for primary surgery. DESIGN, SETTING, AND
participantsProspective nonrandomized phase 2 study at 12 high-volume colorectal surgery centers across Canada. From September 30, 2014, to October 21, 2016, a total of 82 patients were recruited for the study. Participants were patients newly diagnosed as having rectal cancer with MRI-predicted good prognosis rectal cancer. The MRI criteria for good prognosis tumors included distance to the mesorectal fascia greater than 1 mm; definite T2, T2/early T3, or definite T3 with less than 5 mm of extramural depth of invasion; and absent or equivocal extramural venous invasion.
interventionsPatients with rectal cancer with MRI-predicted good prognosis tumors underwent primary surgery. MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion of patients with a positive circumferential resection margin (CRM) rate. Assuming a 10% baseline probability of a positive CRM, a sample size of 75 was estimated to yield a 95% CI of ±6.7%.
resultsEighty-two patients (74% male) participated in the study. The median age at the time of surgery was 66 years (range, 37-89 years). Based on MRI, most tumors were midrectal (65% [n = 53]), T2/early T3 (60% [n = 49]), with no suspicious lymph nodes (63% [n = 52]). On final pathology, 91% (n = 75) of tumors were T2 or greater, 29% (n = 24) were node positive, and 59% (n = 48) were stage II or III. The positive CRM rate was 4 of 82 (4.9%; 95% CI, 0.2%-9.6%). CONCLUSIONS AND RELEVANCE: The use of MRI criteria to select patients with good prognosis rectal cancer for primary surgery results in a low rate of positive CRM and suggests that CRT may not be necessary for all patients with stage II and III rectal cancer.
trial registrationISRCTN.com identifier: ISRCTN05107772.
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