Evidence map›Paper›PMID 39920528›Full record

ArticleAnnals of surgical oncology2025

Predictors of Pathologic Non-response to Neoadjuvant Approaches in Locally Advanced Rectal Cancer.

Jyi Cheng Ng, Annaclara Sileo, Richard Sassun, Sara Aboelmaaty, Tommaso Violante, Ibrahim A Gomaa, Anne-Lise D'Angelo, Kristen K Rumer, Kellie L Mathis, David W Larson

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Article in Annals of surgical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jyi Cheng NgDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Annaclara SileoDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Richard SassunDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Sara AboelmaatyDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Tommaso ViolanteDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Ibrahim A GomaaDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Anne-Lise D'AngeloDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Kristen K RumerDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Kellie L MathisDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA.
David W LarsonDivision of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA. Larson.David2@mayo.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundApproximately 10-20% of rectal cancer patients do not respond to neoadjuvant treatment. While the current literature has focused on pathological complete response, pinpointing those who will fail to benefit entirely from neoadjuvant approaches is crucial.

objectiveThis study aimed to determine the risk factors associated with pathological non-response (pNR) to neoadjuvant treatment.

methodsPatients with stage II-III rectal adenocarcinoma who underwent neoadjuvant treatment followed by curative surgical resection between 2018 and 2023 at a high-volume center were retrospectively reviewed. Patients were divided into two cohorts (pNR and pathologic responder [pR]) based on their response to neoadjuvant therapy. The pNR group included patients with a Tumor Regression Score of grade 3 or those upstaged on the final pathological report.

resultsOf the 405 patients included in this study, 53 (13%) were pNR and 352 (87%) were pR. Among patients treated with standard neoadjuvant chemoradiation, 12% were pNR compared with 14% among those treated with total neoadjuvant therapy. Significantly more patients in the pNR cohort had perineural (31% vs. 8%; p < 0.001) and lymphovascular (22% vs. 6%, p = 0.001) invasions when compared with the pR cohort. After adjusting for age, sex, clinical T stages, and clinical nodal status on multivariable analysis, the presence of extramural vascular invasion (EMVI) on pretreatment magnetic resonance imaging (odds ratio 2.08, 95% confidence interval 1.03-4.20, p = 0.04) was identified as a significant predictor of pNR.

conclusionEMVI was an independent risk factor of pNR in patients with rectal cancer. Identifying pretreatment factors that predict pNR to neoadjuvant therapy is crucial as it allows for better risk stratification and personalized treatment strategies.

Indexed as

AdenocarcinomaChemoradiotherapy, AdjuvantNeoadjuvant TherapyRectal NeoplasmsAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm StagingPrognosisRetrospective StudiesRisk FactorsEMVINeoadjuvant treatmentRectal cancerTreatment response

Identifiers

PMID39920528

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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.