Evidence map›Paper›PMID 41331154›Full record

Observational studyInternational journal of colorectal disease2025

MRI-defined high-risk rectal cancer patients: comparison of treatment response and survival outcomes between total neoadjuvant therapy and neoadjuvant chemoradiotherapy-a propensity score matched analysis.

Ruiting Li, Meng Zhao, Qiong Ma, Zhiyuan Zhang, Rong Li, Fan Xia, Yaqi Wang, Qianyu Zhou, Zhen Zhang, Yajia Gu and 2 more

Abstract readComparative StudyObservational StudyComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study 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

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

1 citing paper in PubMed.

  1. Article
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

12 authors.

Ruiting Li *Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Meng Zhao *Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Qiong MaDepartment of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Zhiyuan ZhangDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Rong LiDepartment of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Fan XiaDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Yaqi WangDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Qianyu ZhouDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Zhen ZhangDepartment of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
Yajia GuDepartment of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
Tong TongDepartment of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. t983352@126.com.
Yiqun SunDepartment of Radiology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. 12211230032@fudan.edu.cn.

Funding

National Natural Science Foundation of China 81971687National Natural Science Foundation of China 82001776Shanghai Shenkang Hospital Development Center SHDC2023CRD014
6 · The paper itself

Abstract

purposeThis study evaluated whether total neoadjuvant therapy (TNT), compared to neoadjuvant chemoradiotherapy (nCRT), improves response and prognosis in magnetic resonance imaging (MRI)-defined high-risk patients with locally advanced rectal cancer (LARC).

methodsThis retrospective cohort study ultimately included 791 patients with pathologically confirmed rectal cancer who underwent baseline rectal MRI at our institution between 2015 and 2022. Independent MRI-based prognostic risk factors were identified through multivariable Cox regression analysis. Propensity score matching (PSM) was employed to control for confounding variables, followed by survival and treatment response analyses between groups.

resultsThe Cox model revealed that MR-based T4 stage and extramural venous invasion (EMVI) status significantly impacted overall survival (OS), whereas tumor location and mesorectal fascia invasion (MRF) status served as important predictors of disease-free survival (DFS). After PSM, the MRI-defined TNT group exhibited a significantly higher clinical complete response (cCR) rate (25.8% vs. 4.0%, p < 0.001), thus leading to more frequent adoption of the watch and wait (W&W) strategy. Furthermore, Kaplan-Meier (KM) curve analysis ultimately confirmed that, compared with the nCRT group, the TNT group exhibited superior OS (HR = 0.48, 95% CI 0.27-0.86) and DFS (HR = 0.62, 95% CI 0.39-1).

conclusionIn MRI-defined high-risk LARC patients, TNT could improve the survival trend while increasing the likelihood of organ preservation without exacerbating surgical complexity. These findings emphasize the fact that TNT should be prioritized for the high-risk MRI-defined population to achieve enhanced local tumor control, sustained therapeutic efficacy, and prolonged survival.

Indexed as

Antineoplastic AgentsChemoradiotherapyMagnetic Resonance ImagingNeoadjuvant TherapyRectal NeoplasmsAgedDisease-Free SurvivalFemaleHumansKaplan-Meier EstimateMaleMiddle AgedNeoplasm InvasivenessNeoplasm StagingPathologic Complete ResponsePrognosisAntineoplastic AgentsAdjuvant radiotherapy and chemotherapyMagnetic resonance imagingRectal cancerSurvival analysis

Identifiers

PMID41331154
PMCPMC12672846

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Registered trials

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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.