Predicting Difficult Laparoscopic Total Mesorectal Excision for Locally-advanced Mid-low Rectal Cancer: The


Journal

Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988

Informations de publication

Date de publication:
Apr 2020
Historique:
received: 14 02 2020
revised: 24 02 2020
accepted: 27 02 2020
entrez: 3 4 2020
pubmed: 3 4 2020
medline: 11 4 2020
Statut: ppublish

Résumé

The European MRI and Rectal Cancer Surgery (EuMaRCS) score was proposed to identify preoperatively difficult laparoscopic total mesorectal excision (L-TME) for locally advanced rectal cancer (LARC). This study aimed to test EuMaRCS's validity. Data were retrieved from a European multicenter database, including patients with mid/low LARC, treated with neoadjuvant chemoradiation therapy and L-TME with primary anastomosis. The EuMaRCS score was calculated on: BMI>30 (3 points), interspinous distance<96.4 mm (2 points), ymrT stage≥T3b (4 points), and male sex (1 point). The sample was composed of 141 patients, of whom 23 (16.3%) had a difficult L-TME. The EuMaRCS score demonstrated high accuracy in predicting difficult surgery (AROC: 0.806, 95%CI=0.72-0.88), with a cut-off >3 being associated with the best balance in sensitivity (82.6%) and specificity (66.1%). The EuMaRCS score represents a validated tool to predict preoperatively difficult L-TME in LARC patients.

Sections du résumé

BACKGROUND/AIM OBJECTIVE
The European MRI and Rectal Cancer Surgery (EuMaRCS) score was proposed to identify preoperatively difficult laparoscopic total mesorectal excision (L-TME) for locally advanced rectal cancer (LARC). This study aimed to test EuMaRCS's validity.
PATIENTS AND METHODS METHODS
Data were retrieved from a European multicenter database, including patients with mid/low LARC, treated with neoadjuvant chemoradiation therapy and L-TME with primary anastomosis. The EuMaRCS score was calculated on: BMI>30 (3 points), interspinous distance<96.4 mm (2 points), ymrT stage≥T3b (4 points), and male sex (1 point).
RESULTS RESULTS
The sample was composed of 141 patients, of whom 23 (16.3%) had a difficult L-TME. The EuMaRCS score demonstrated high accuracy in predicting difficult surgery (AROC: 0.806, 95%CI=0.72-0.88), with a cut-off >3 being associated with the best balance in sensitivity (82.6%) and specificity (66.1%).
CONCLUSION CONCLUSIONS
The EuMaRCS score represents a validated tool to predict preoperatively difficult L-TME in LARC patients.

Identifiants

pubmed: 32234900
pii: 40/4/2079
doi: 10.21873/anticanres.14166
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2079-2087

Informations de copyright

Copyright© 2020, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Auteurs

Nicola de'ANGELIS (N)

Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France nic.deangelis@yahoo.it.

Aleix Martínez-Pérez (A)

Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain.

Giulio Cesare Vitali (GC)

Service of Abdominal Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland.

Frederic Pigneur (F)

Department of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.

Alain Luciani (A)

Department of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.

Francesco Brunetti (F)

Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.

Miquel Kraft (M)

Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Vall d'Hebron, Barcelona, Spain.

Eva Martí-Martínez (E)

Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain.

Paolo Moroni (P)

1 Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padua, Italy.

Eloy Espin (E)

Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Vall d'Hebron, Barcelona, Spain.

Frederic Ris (F)

Department of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France.

Salvatore Pucciarelli (S)

1 Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padua, Italy.

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Classifications MeSH