ArticleThe British journal of surgery2020
MRI cT1-2 rectal cancer staging accuracy: a population-based study.
Article in The British journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04103372 (Pre-therapeutic MRI Assessment of Early-Stage Rectal Cancer and Significant Rectal Polyps to Avoid Major Resectional Surgery), which is not on this map. Cited by 40 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Pre-therapeutic MRI Assessment of Early-Stage Rectal Cancer and Significant Rectal Polyps to Avoid Major Resectional Surgery
Who cites it
40 citing papers in PubMed, 1 synthesis or guideline pooled it, 91 citations in OpenAlex.
- Local recurrence after local excision of early rectal cancer: a meta-analysis of completion TME, adjuvant (chemo)radiation, or no additional treatment.The British journal of surgery · 2020Pooled it
- CEA-targeted fluorescence endoscopy for the detection of high-grade dysplasia and early invasive rectal cancer: A proof-of-concept trial.European journal of nuclear medicine and molecular imaging · 2026Article
- Pathologic upstaging after definitive transanal endoscopic surgery for cT1N0M0 rectal cancer: patterns of care and survival.Surgical endoscopy · 2026Article
- Contrast-enhanced MRI improves diagnostic accuracy in stage Tis-T1 rectal cancer: a head-to-head comparison with endorectal ultrasound.European radiology · 2026Article
- Evaluating the usefulness of 18F-FDG PET/MR in rectal cancer staging: a prospective comparison with histopathological findings.International journal of colorectal disease · 2026Article
- Diagnostic Performance of CT, MRI, and ERUS in Preoperative T- and N-Staging of Colorectal Cancer: A Retrospective Single-Center Analysis.Journal of gastrointestinal cancer · 2026Article
- Pretreatment MRI Versus Postoperative Pathology in Locoregional Staging of Rectal Cancer: A Germany-Wide Multicenter Re-Evaluation Study in Non-Pretreated Patients Based on the OCUM Study.Deutsches Arzteblatt international · 2026Observational
- Application of a MRI model based on tumor microenvironment habitat and peritumoral features in preoperative differentiation of rectal cancer T1-2/T3: a multicenter study.Frontiers in medicine · 2026Article
- Assessing the accuracy of magnetic resonance imaging in identifying early rectal cancers suitable for endoscopic intermuscular dissection.Endoscopy · 2025Article
- Application of diffusion kurtosis imaging in differentiating T0-T1 from T2 rectal tumors.Cancer imaging : the official publication of the International Cancer Imaging Society · 2025Article
- Multimodal Preoperative Management of Rectal Cancer: A Review of the Existing Guidelines.Medicina (Kaunas, Lithuania) · 2025Review
- MRI of early rectal cancer; bisacodyl micro-enema increases submucosal width, reader confidence, and tumor conspicuity.Abdominal radiology (New York) · 2025Article
- Endoscopic Resection Techniques for Widespread Precancerous Lesions and Early Carcinomas in the Rectum.Journal of clinical medicine · 2025Review
- Early rectal cancer: are we overstaging and overtreating?BJS open · 2025Article
- Review
- Therapeutic Management of Locally Advanced Rectal Cancer: Existing and Prospective Approaches.Journal of clinical medicine · 2025Review
- Linear endo-ultrasonographic signs of muscularis propria invasion in early rectal cancer.Techniques in coloproctology · 2024Article
- Deep learning for segmentation of colorectal carcinomas on endoscopic ultrasound.Techniques in coloproctology · 2024Article
- Endoscopic Local Excision (ELE) with Knife-Assisted Resection (KAR) Techniques Followed by Adjuvant Radiotherapy and/or Chemotherapy for Invasive (T1bsm2,3/T2) Early Rectal Cancer: A Multicenter Retrospective Cohort.Journal of clinical medicine · 2024Article
- Tumor Response and Its Impact on Treatment Failure in Rectal Cancer: Does Intensity of Neoadjuvant Treatment Matter?Cancers · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdequate MRI-based staging of early rectal cancers is essential for decision-making in an era of organ-conserving treatment approaches. The aim of this population-based study was to determine the accuracy of routine daily MRI staging of early rectal cancer, whether or not combined with endorectal ultrasonography (ERUS).
methodsPatients with cT1-2 rectal cancer who underwent local excision or total mesorectal excision (TME) without downsizing (chemo)radiotherapy between 1 January 2011 and 31 December 2018 were selected from the Dutch ColoRectal Audit. The accuracy of imaging was expressed as sensitivity, specificity, and positive predictive value (PPV) and negative predictive value.
resultsOf 7382 registered patients with cT1-2 rectal cancer, 5539 were included (5288 MRI alone, 251 MRI and ERUS; 1059 cT1 and 4480 cT2). Among patients with pT1 tumours, 54·7 per cent (792 of 1448) were overstaged by MRI alone, and 31·0 per cent (36 of 116) by MRI and ERUS. Understaging of pT2 disease occurred in 8·2 per cent (197 of 2388) and 27·9 per cent (31 of 111) respectively. MRI alone overstaged pN0 in 17·3 per cent (570 of 3303) and the PPV for assignment of cN0 category was 76·3 per cent (2733 of 3583). Of 834 patients with pT1 N0 disease, potentially suitable for local excision, tumours in 253 patients (30·3 per cent) were staged correctly as cT1 N0, whereas 484 (58·0 per cent) and 97 (11·6 per cent) were overstaged as cT2 N0 and cT1-2 N1 respectively.
conclusionThis Dutch population-based analysis of patients who underwent local excision or TME surgery for cT1-2 rectal cancer based on preoperative MRI staging revealed substantial overstaging, indicating the weaknesses of MRI and missed opportunities for organ preservation strategies.
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Registered trials
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.