Evidence map›Paper›PMID 41204004›Full record

ArticleInternational journal of colorectal disease2025

Relationship between fibrosis induced by preoperative chemoradiotherapy and real-time tissue elastography of internal anal sphincter.

Akira Sakamoto, Kazuhito Sasaki, Hiroyuki Abe, Ryosuke Kikuchi, Hiroaki Nozawa, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Yuzo Nagai, Shinya Abe and 5 more

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Article in International journal of colorectal disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

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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

1 citing paper in PubMed.

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4 · The record

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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

15 authors.

Akira SakamotoDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Kazuhito SasakiDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan. sasakik-tky@umin.ac.jp.ORCID http://orcid.org/0000-0003-3569-6944
Hiroyuki AbeDepartment of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Ryosuke KikuchiDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Hiroaki NozawaDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Koji MuronoDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Shigenobu EmotoDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Yuichiro YokoyamaDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Yuzo NagaiDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Shinya AbeDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Takahide ShinagawaDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Yuichi TachikawaDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Satoshi OkadaDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Tetsuo UshikuDepartment of Pathology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
Soichiro IshiharaDepartment of Surgical Oncology, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt has been suggested that chemoradiotherapy may cause fibrosis of the internal anal sphincter, resulting in sclerosis. However, no report has quantitatively investigated this relationship by using real-time tissue elastography.

objectiveTo clarify the relationship between fibrosis and elasticity of the internal anal sphincter in patients undergoing surgery for lower rectal cancer with or without preoperative chemoradiotherapy from a histological perspective.

designA single-center, prospective cohort study. SETTINGS: The surgical and pathological departments in a tertiary referral university hospital. PATIENTS: Eighteen patients with rectal cancer who underwent abdominoperineal resection between May 2019 and May 2022 were included in the study.

main outcome measuresReal-time tissue elastography was performed before surgery to measure internal anal sphincter hardness as "elasticity" (hardest (0) to softest (255); decreased elasticity indicated sclerotic changes). Internal anal sphincter fibrosis was evaluated using Masson's trichrome and Elastica van Gieson staining. We evaluated internal anal sphincter elasticity after preoperative chemoradiotherapy and preoperatively in patients who did not undergo preoperative chemoradiotherapy and analyzed the correlation with the percentage of internal anal sphincter fibrosis in the resected specimens.

resultsOf the 18 patients, 10 underwent preoperative chemoradiotherapy. A significantly higher percentage of internal anal sphincter fibrosis was observed in the chemoradiotherapy group. Post-chemoradiotherapy elasticity was significantly lower in patients undergoing chemoradiotherapy compared to pre-chemoradiotherapy elasticity and that in patients not undergoing chemoradiotherapy. The analysis of the correlation between internal anal sphincter elasticity and fibrosis showed that elasticity decreased as the percentage of fibrosis increased. LIMITATIONS: This study was conducted at a single institution, and the number of cases was small. The radiation dose to the anal canal may have differed depending on the location of the tumor, which may have affected internal anal sphincter elasticity.

conclusionsInternal anal sphincter elasticity may reflect tissue sclerosis associated with fibrosis caused by chemoradiotherapy.

Indexed as

Anal CanalChemoradiotherapyElasticity Imaging TechniquesRectal NeoplasmsAgedFemaleFibrosisHumansMaleMiddle AgedPreoperative CareColorectal cancerPreoperative chemoradiotherapyReal-time tissue elastography

Identifiers

PMID41204004
PMCPMC12594675

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