Trial reportThe British journal of surgery2024
Baseline MRI predictors of successful organ preservation in the Organ Preservation in Rectal Adenocarcinoma (OPRA) trial.
Trial report in The British journal of surgery, 2024. 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 7 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
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Watch-and-Wait strategy for locally advanced rectal cancer after neoadjuvant chemoradiotherapy: a comprehensive review.Frontiers in oncology · 2026Pooled it
- Report from the 27th Annual Western Canadian Gastrointestinal Cancer Consensus Conference on Colorectal Cancer, Calgary, Alberta, 26-27 September 2025: Advances in Colon and Rectal Cancer.Current oncology (Toronto, Ont.) · 2026Article
- Nomogram for predicting lymph node metastasis in ypT0-2 rectal cancer after neoadjuvant chemoradiotherapy.International journal of colorectal disease · 2026Article
- MRI's evolving role in rectal cancer in the era of personalized medicine.Abdominal radiology (New York) · 2026Review
- Baseline Magnetic Resonance Imaging Assessment of Circumferential Resection Margin Predicts Long-term Survival in Rectal Adenocarcinoma: Experience from a Tertiary Care Center.Indian journal of surgical oncology · 2026Article
- Enhancing the role of MRI in rectal cancer: advances from staging to prognosis prediction.European radiology · 2025Review
- Nonoperative management of rectal cancer.Frontiers in oncology · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
11 authors.
Funding
Abstract
backgroundProspective randomized trials have not yet identified baseline features predictive of organ preservation in locally advanced rectal cancers treated with total neoadjuvant therapy and a selective watch-and-wait strategy.
methodsThis was a secondary analysis of the OPRA trial, which randomized patients with stage II-III rectal adenocarcinoma to receive either induction or consolidation total neoadjuvant therapy. Patients were recommended for total mesorectal excision, or watch and wait based on clinical response at 8 ± 4 weeks after completing treatment. Standardized baseline clinical and radiological variables were collected prospectively. Survival outcomes, including total mesorectal excision-free survival, disease-free survival, and overall survival, were assessed by intention-to-treat analysis. Cox proportional hazards models were used to evaluate associations between baseline variables and survival outcomes.
resultsOf the 324 patients randomized for the OPRA trial, 38 (11.7%) had cT4 tumours, 230 (71.0%) cN-positive disease, 101 (32.5%) mesorectal fascia involvement, and 64 (19.8%) extramural venous invasion. Several baseline features were independently associated with recommendation for total mesorectal excision on multivariable analysis: nodal disease (HR 1.66, 95% c.i. 1.12 to 2.48), extramural venous invasion (HR 1.57, 1.07 to 2.29), mesorectal fascia involvement (HR 1.45, 1.01 to 2.09), and tumour length (HR 1.11, 1.00 to 1.22). Of these, nodal disease (HR 2.02, 1.15 to 3.53) and mesorectal fascia involvement (HR 2.02, 1.26 to 3.26) also predicted worse disease-free survival. Age (HR 1.03, 1.00 to 1.06) was associated with overall survival.
conclusionBaseline MRI features, including nodal disease, extramural venous invasion, mesorectal fascia involvement, and tumour length, independently predict the likelihood of organ preservation after completion of total neoadjuvant therapy. Mesorectal fascia involvement and nodal disease are associated with disease-free survival.
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