Evidence map›Paper›PMID 31842784›Full record

ArticleBMC cancer2019

Standard (8 weeks) vs long (12 weeks) timing to minimally-invasive surgery after NeoAdjuvant Chemoradiotherapy for rectal cancer: a multicenter randomized controlled parallel group trial (TiMiSNAR).

Igor Monsellato, Filippo Alongi, Elisa Bertocchi, Stefania Gori, Giacomo Ruffo, Elisa Cassinotti, Ludovica Baldari, Luigi Boni, Graziano Pernazza, Fabio Pulighe and 27 more

Erratum issuedOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 21% 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

5 citing papers in PubMed, 14 citations in OpenAlex.

  1. Results of radical treatment of locally advanced rectal cancer in geriatric and non-geriatric patients.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2025
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

37 authors at 13 institutions in 1 country.

Igor MonsellatoAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy. igor.monsellato@ospedale.al.it.ORCID 0000-0003-3096-7901
Filippo AlongiOspedale Sacro Cuore Don Calabria, Negrar, Italy.
Elisa BertocchiOspedale Sacro Cuore Don Calabria, Negrar, Italy.
Stefania GoriOspedale Sacro Cuore Don Calabria, Negrar, Italy.
Giacomo RuffoOspedale Sacro Cuore Don Calabria, Negrar, Italy.
Elisa CassinottiDepartment of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Ludovica BaldariDepartment of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Luigi BoniDepartment of Surgery, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, University of Milan, Milan, Italy.
Graziano PernazzaAzienda Ospedaliera San Giovanni Addolorata, Rome, Italy.
Fabio PuligheOspedale San Francesco, Nuoro, Italy.
Carlo De NiscoOspedale San Francesco, Nuoro, Italy.
Roberto PerinottiOspedale degli Infermi, Biella, Italy.
Emilio MorpurgoOspedale Civile Pietro Cosma, Camposampiero/Ospedale Sant'Antonio, Padova, Italy.
Tania ContardoOspedale Civile Pietro Cosma, Padova, Camposampiero, Italy.
Enzo MammanoOspedale Civile Pietro Cosma, Camposampiero/Ospedale Sant'Antonio, Padova, Italy.
Ugo ElmoreOspedale San raffaele IRCCS, Milan, Italy.
Roberto DelpiniOspedale San raffaele IRCCS, Milan, Italy.
Riccardo RosatiOspedale San raffaele IRCCS, Milan, Italy.
Federico PernaAzienda Ospedaliero Universitaria Careggi, Florence, Italy.
Andrea CorattiAzienda Ospedaliero Universitaria Careggi, Florence, Italy.
Benedetta MenegattiAzienda Ospedaliero Universitaria Careggi, Florence, Italy.
Sergio GentilliAzienda Ospedaliero Universitaria Maggiore Della Carità, Novara, Italy.
Paolo BaroffioAzienda Ospedaliero Universitaria Maggiore Della Carità, Novara, Italy.
Piero BucciantiAzienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Riccardo BalestriAzienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Cristina CeccarelliAzienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Valter TorriIstituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
Davide CavaliereOspedale G.B. Morgagni L. Pierantoni, Forlì, Italy.
Leonardo SolainiOspedale G.B. Morgagni L. Pierantoni, Forlì, Italy.
Giorgio ErcolaniOspedale G.B. Morgagni L. Pierantoni, Forlì, Italy.
Elena TraversoAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Vittorio FuscoAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Maura RossiAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Fabio PrioraAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
G NumicoAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Paola FranzoneAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Sara OrecchiaAzienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo · ITOspedale Sacro Cuore Don Calabria · ITAzienda Ospedaliera Universitaria Pisana · ITAzienda Ospedaliero-Universitaria Careggi · ITIRCCS Ospedale San Raffaele · ITOspedale G.B. Morgagni - L.Pierantoni · ITUniversity of Milan · ITOspedale Sant Antonio · ITUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro” · ITAzienda Ospedaliera San Giovanni Addolorata · ITMario Negri Institute for Pharmacological Research · ITOspedale degli Infermi · ITOspedale San Pietro Fatebenefratelli · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe optimal timing of surgery in relation to chemoradiation is still controversial. Retrospective analysis has demonstrated in the recent decades that the regression of adenocarcinoma can be slow and not complete until after several months. More recently, increasing pathologic Complete Response rates have been demonstrated to be correlated with longer time interval. The purpose of the trial is to demonstrate if delayed timing of surgery after neoadjuvant chemoradiotherapy actually affects pathologic Complete Response and reflects on disease-free survival and overall survival rather than standard timing.

methodsThe trial is a multicenter, prospective, randomized controlled, unblinded, parallel-group trial comparing standard and delayed surgery after neoadjuvant chemoradiotherapy for the curative treatment of rectal cancer. Three-hundred and forty patients will be randomized on an equal basis to either robotic-assisted/standard laparoscopic rectal cancer surgery after 8 weeks or robotic-assisted/standard laparoscopic rectal cancer surgery after 12 weeks. DISCUSSION: To date, it is well-know that pathologic Complete Response is associated with excellent prognosis and an overall survival of 90%. In the Lyon trial the rate of pCR or near pathologic Complete Response increased from 10.3 to 26% and in retrospective studies the increase rate was about 23-30%. These results may be explained on the relationship between radiation therapy and tumor regression: DNA damage occurs during irradiation, but cellular lysis occurs within the next weeks. Study results, whether confirmed that performing surgery after 12 weeks from neoadjuvant treatment is advantageous from a technical and oncological point of view, may change the current pathway of the treatment in those patient suffering from rectal cancer.

trial registrationClinicalTrials.gov NCT3465982.

Indexed as

AdenocarcinomaChemoradiotherapyLaparoscopyNeoadjuvant TherapyRectal NeoplasmsAdultAgedDisease-Free SurvivalHumansMiddle AgedMinimally Invasive Surgical ProceduresMulticenter Studies as TopicPrognosisProspective StudiesRandomized Controlled Trials as TopicTime FactorsMinimally invasive surgeryNeoadjuvant treatmentRadiation therapyRectal cancerRobotic surgeryTaTMETiming to surgery

Identifiers

PMID31842784
PMCPMC6912945
OpenAlexW2996140868

What OpenQuestion holds

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LicenceCC BY
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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.