Evidence map›Paper›PMID 31108012›Full record

ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2019

Changes in the multidisciplinary management of rectal cancer from 2009 to 2015 and associated improvements in short-term outcomes.

C S D Roxburgh, P Strombom, P Lynn, A Cercek, M Gonen, J J Smith, L K F Temple, G M Nash, J G Guillem, P B Paty and 13 more

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing 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

7 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

C S D RoxburghDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
P StrombomDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
P LynnDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
A CercekDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
M GonenDepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
J J SmithDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
L K F TempleDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
G M NashDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
J G GuillemDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
P B PatyDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
J ShiaDepartment of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
E VakianiDepartment of Pathology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
R YaegerDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
Z K StadlerDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
N H SegalDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
D ReidyDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
A VargheseDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
A J WuDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
C H CraneDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
M J GollubDepartment of Radiology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
L B SaltzDepartment of Medicine, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
J Garcia-AguilarDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.
M R WeiserDepartment of Surgery, Memorial Sloan Kettering Cancer Center, New York City, New York, USA.

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

aimSignificant recent changes in management of locally advanced rectal cancer (LARC) include preoperative staging, use of extended neoadjuvant therapies and minimally invasive surgery (MIS). This study was aimed at characterizing these changes and associated short-term outcomes.

methodWe retrospectively analysed treatment and outcome data from patients with T3/4 or N+ LARC ≤ 15 cm from the anal verge who were evaluated at a comprehensive cancer centre in 2009-2015.

resultsIn total, 798 patients were identified and grouped into five cohorts based on treatment year: 2009-2010, 2011, 2012, 2013 and 2014-2015. Temporal changes included increased reliance on MRI staging, from 57% in 2009-2010 to 98% in 2014-2015 (P < 0.001); increased use of total neoadjuvant therapy, from 17% to 76% (P < 0.001); and increased use of MIS, from 33% to 70% (P < 0.001). Concurrently, median hospital stay decreased (from 7 to 5 days; P < 0.001), as did the rates of Grade III-V complications (from 13% to 7%; P < 0.05), surgical site infections (from 24% to 8%; P < 0.001), anastomotic leak (from 11% to 3%; P < 0.05) and positive circumferential resection margin (from 9% to 4%; P < 0.05). TNM downstaging increased from 62% to 74% (P = 0.002).

conclusionShifts toward MRI-based staging, total neoadjuvant therapy and MIS occurred between 2009 and 2015. Over the same period, treatment responses improved, and lengths of stay and the incidence of complications decreased.

Indexed as

Disease ManagementAgedFemaleHumansLength of StayMaleMargins of ExcisionMiddle AgedNeoadjuvant TherapyNeoplasm GradingNeoplasm StagingPatient Care TeamProctectomyRectal NeoplasmsRetrospective StudiesTime FactorsComplicationsMinimally invasive surgeryMRIRectal cancerResponse to treatmentTotal neoadjuvant therapy

Identifiers

PMID31108012
PMCPMC6773478

What OpenQuestion holds

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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.