ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2023
Prospective Correlation of Magnetic Resonance Tumor Regression Grade With Pathologic Outcomes in Total Neoadjuvant Therapy for Rectal Adenocarcinoma.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02921256 (A Phase II Clinical Trial Platform of Sensitization Utilizing Total Neoadjuvant Therapy), which is not on this map. Cited by 32 papers, 2 of them syntheses 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.
A Phase II Clinical Trial Platform of Sensitization Utilizing Total Neoadjuvant Therapy (TNT) in Rectal Cancer
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Oncovascular Resection in Pelvic Exenteration: A Systematic Review.ANZ journal of surgery · 2026Pooled it
- The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0.Annals of coloproctology · 2026Guideline
- Preoperative MRI assessment of rectal cancer for predicting metastasis-free survival-a post hoc analysis of a randomized controlled clinical trial.European radiology · 2026Trial
- MRI Predicts Residual Disease and Outcomes in Watch-and-Wait Patients with Rectal Cancer.Radiology · 2024Trial
- CT-derived extracellular volume fraction and AI-assisted body composition for predicting neoadjuvant therapy response and prognosis in colorectal cancer.Abdominal radiology (New York) · 2026Article
- Low SLC8A1 in Colorectal Cancer Dictates Radiotherapy Resistance Through Calcium-Dependent ANXA2Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Article
- SIRT1 Inhibits T-cell Infiltration and Tertiary Lymphoid Structure Formation to Promote Radioimmunotherapy Resistance.Cancer research · 2026Article
- Digital rectal examination in rectal cancer response assessment: clinical performance and the need for standardized reporting.Techniques in coloproctology · 2026Article
- Magnetic Resonance Imaging After Total Neoadjuvant Therapy in Rectal Cancer: Treatment-Oriented Response Assessment and Reporting for Watch-and-Wait Management.Korean journal of radiology · 2026Review
- MRI to guide clinical management of rectal cancer: updated consensus recommendations from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR): PART II-Restaging and response evaluation.European radiology · 2026Article
- Clinical and treatment-related predictors of complete response after total neoadjuvant therapy for rectal cancer in a large multicenter analysis.Clinical and translational radiation oncology · 2026Article
- Preoperative Magnetic Resonance Imaging Results Are Concordant with Pathology Staging in Rectal Cancer.Medicina (Kaunas, Lithuania) · 2026Article
- How best to combine DWI and T2WI to predict pathologic complete response: a multi-center study on interpreting MRI following chemoradiotherapy of rectal cancer.European radiology · 2026Article
- Case report: complete pathologic response to neoadjuvant ensartinib in locally advanced, ALK-positive lung squamous cell carcinoma.Frontiers in oncology · 2026Article
- Case Report: Ultrasound features of pathological complete response in middle and low rectal cancer with high microsatellite instability after neoadjuvant immunotherapy: a case series.Frontiers in immunology · 2026Article
- Article
- The predictive value of multi-phase contrast-enhanced MRI for pathological complete response after neoadjuvant chemoradiotherapy in rectal cancer.Frontiers in oncology · 2026Article
- Arterial-phase mucosal linear enhancement as an indicator of pathological complete response after immunotherapy in pMMR/MSS locally advanced rectal cancer.La Radiologia medica · 2025Article
- Accuracy of Flexible Sigmoidoscopy and MRI in Restaging Rectal Cancer after Neoadjuvant Therapy: A Secondary Analysis of the OPRA Randomized Clinical Trial.Annals of surgery · 2025Article
- Enhanced prognosis prediction model in esophageal cancer via lymph node assessment post-neoadjuvant.BMC cancer · 2025Article
Corrections and comments
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Authors and funding
20 authors at 18 institutions in 1 country.
Funding
Abstract
purposeTotal neoadjuvant therapy (TNT) is a newly established standard treatment for rectal adenocarcinoma. Current methods to communicate magnitudes of regression during TNT are subjective and imprecise. Magnetic resonance tumor regression grade (MR-TRG) is an existing, but rarely used, regression grading system. Prospective validation of MR-TRG correlation with pathologic response in patients undergoing TNT is lacking. Utility of adding diffusion-weighted imaging to MR-TRG is also unknown.
methodsWe conducted a multi-institutional prospective imaging substudy within NRG-GI002 (ClinicalTrials.gov identifier: NCT02921256) examining the ability of MR-based imaging to predict pathologic complete response (pCR) and correlate MR-TRG with the pathologic neoadjuvant response score (NAR). Serial MRIs were needed from 110 patients. Three radiologists independently, then collectively, reviewed each MRI for complete response (mriCR), which was tested for positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity with pCR. MR-TRG was examined for association with the pathologic NAR score. All team members were blinded to pathologic data.
resultsA total of 121 patients from 71 institutions met criteria: 28% were female (n = 34), 84% White (n = 101), and median age was 55 (24-78 years). Kappa scores for T- and N-stage after TNT were 0.38 and 0.88, reflecting fair agreement and near-perfect agreement, respectively. Calling an mriCR resulted in a kappa score of 0.82 after chemotherapy and 0.56 after TNT reflected near-perfect agreement and moderate agreement, respectively. MR-TRG scores were associated with pCR (
conclusionMRI alone is a poor tool to distinguish pCR in rectal adenocarcinoma undergoing TNT. However, the MR-TRG score presents a now validated method, correlated with pathologic NAR, which can objectively measure regression magnitude during TNT.
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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.