Impact of the new rectal cancer definition on multimodality treatment and interhospital variability: Results from a nationwide cross-sectional study.
rectal cancer
rectosigmoid
sigmoid cancer
sigmoid take‐off
treatment
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
29 Apr 2024
29 Apr 2024
Historique:
revised:
27
09
2023
received:
07
02
2023
accepted:
19
03
2024
medline:
29
4
2024
pubmed:
29
4
2024
entrez:
29
4
2024
Statut:
aheadofprint
Résumé
This study aimed to determine the consequences of the new definition of rectal cancer for decision-making in multidisciplinary team meetings (MDT). The new definition of rectal cancer, the lower border of the tumour is located below the sigmoid take-off (STO), was implemented in the Dutch guideline in 2019 after an international Delphi consensus meeting to reduce interhospital variations. All patients with rectal cancer according to the local MDT, who underwent resection in 2016 in the Netherlands were eligible for this nationwide collaborative cross-sectional study. MRI-images were rereviewed, and the tumours were classified as above or on/below the STO. This study registered 3107 of the eligible 3178 patients (98%), of which 2784 patients had an evaluable MRI. In 314 patients, the tumour was located above the STO (11%), with interhospital variation between 0% and 36%. Based on TN-stage, 175 reclassified patients with colon cancer (6%) would have received different treatment (e.g., omitting neoadjuvant radiotherapy, candidate for adjuvant chemotherapy). Tumour location above the STO was independently associated with lower risk of 4-year locoregional recurrence (HR 0.529; p = 0.030) and higher 4-year overall survival (HR 0.732; p = 0.037) compared to location under the STO. By using the STO, 11% of the prior MDT-based diagnosis of rectal cancer were redefined as sigmoid cancer, with potential implications for multimodality treatment and prognostic value. Given the substantial interhospital variation in proportion of redefined cancers, the use of the STO will contribute to standardisation and comparability of outcomes in both daily practice and trial settings.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : KWF Kankerbestrijding
Organisme : Dutch Cancer Society (KWF)
ID : 12768
Investigateurs
Arend G J Aalbers
(AGJ)
Susanna M van Aalten
(SM)
Femke J Amelung
(FJ)
Marjolein Ankersmit
(M)
Imogeen E Antonisse
(IE)
Jesse F Ashruf
(JF)
Tjeerd S Aukema
(TS)
Henk Avenarius
(H)
Renu R Bahadoer
(RR)
Frans C H Bakers
(FCH)
Ilsalien S Bakker
(IS)
Fleur Bangert
(F)
Renée M Barendse
(RM)
Heleen M D Beekhuis
(HMD)
Geerard L Beets
(GL)
Willem A Bemelman
(WA)
Maaike Berbée
(M)
Shira H de Bie
(SH)
Robert H C Bisschops
(RHC)
Liselotte W van Bockel
(LW)
Anniek H Boer
(AH)
Frank C den Boer
(FC)
Evert-Jan G Boerma
(EG)
Leonora S F Boogerd
(LSF)
Jaap Borstlap
(J)
Wernard A A Borstlap
(WAA)
Robin D Blok
(RD)
Johanna E Bouwman
(JE)
Sicco J Braak
(SJ)
Manon N G J A Braat
(MNGJA)
Jennifer Bradshaw
(J)
Amarins T A Brandsma
(ATA)
Vivian van Breest Smallenburg
(V)
Wim T van den Broek
(WT)
Sjirk W van der Burg
(SW)
Jacobus W A Burger
(JWA)
Thijs A Burghgraef
(TA)
David W G Ten Cate
(DWG)
Heleen M Ceha
(HM)
Jeltsje S Cnossen
(JS)
Robert J Coebergh van den Braak
(RJ)
Esther C J Consten
(ECJ)
Maaike Corver
(M)
Rogier M P H Crolla
(RMPH)
Sam Curutchet
(S)
Alette W Daniëls-Gooszen
(AW)
Paul H P Davids
(PHP)
Emmelie N Dekker
(EN)
Jan Willem T Dekker
(JWT)
Ahmet Demirkiran
(A)
Tyche Derksen
(T)
Arjen L Diederik
(AL)
Anne M Dinaux
(AM)
Kemal Dogan
(K)
Ilse M van Dop
(IM)
Kitty E Droogh-de Greve
(KE)
Hanneke Duijsens
(H)
Michalda S Dunker
(MS)
Johan Duyck
(J)
Eino B van Duyn
(EB)
Laurentine S E van Egdom
(LSE)
Bram Eijlers
(B)
Youssef El-Massoudi
(Y)
Saskia van Elderen
(S)
Anouk M L H Emmen
(AMLH)
Marc Engelbrecht
(M)
Anne C van Erp
(AC)
Jeroen A van Essen
(JA)
Hans F J Fabry
(HFJ)
Thomas Fassaert
(T)
Eline A Feitsma
(EA)
Shirin S Feshtali
(SS)
Bas Frietman
(B)
Edgar J B Furnée
(EJB)
Anne van Geel
(A)
Elisabeth D Geijsen
(ED)
Nanette van Geloven
(N)
Michael F Gerhards
(MF)
Hugo Gielkens
(H)
Renza van Gils
(R)
Lucas Goense
(L)
Marc J P M Govaert
(MJPM)
Wilhelmina M U van Grevenstein
(WMU)
Elisabeth J de Groof
(EJ)
Irene de Groot
(I)
Robbert J de Haas
(RJ)
Nadia A G Hakkenbrak
(NAG)
Mariska D den Hartogh
(MD)
Vera Heesink
(V)
Joost T Heikens
(JT)
Ellen M Hendriksen
(EM)
Sjoerd van den Hoek
(S)
Erik J R J van der Hoeven
(EJRJ)
Christiaan Hoff
(C)
Anna Hogewoning
(A)
Cornelis R C Hogewoning
(CRC)
Stefan Hoogendoorn
(S)
Francois van Hoorn
(F)
René L van der Hul
(RL)
Rieke van Hulst
(R)
Farshad Imani
(F)
Bas Inberg
(B)
Martijn P W Intven
(MPW)
Pedro Janssen
(P)
Chris E J de Jong
(CEJ)
Jacoline Jonkers
(J)
Daniela Jou-Valencia
(D)
Bas Keizers
(B)
Stijn H J Ketelaers
(SHJ)
Eva Knöps
(E)
Sebastiaan van Koeverden
(S)
Sylvia Kok
(S)
Stephanie E M Kolderman
(SEM)
Fleur I de Korte
(FI)
Robert T J Kortekaas
(RTJ)
Julie C Korving
(JC)
Ingrid M Koster
(IM)
Jasenko Krdzalic
(J)
Pepijn Krielen
(P)
Leonard F Kroese
(LF)
Eveline Krul
(E)
Derk Lahuis
(D)
Bas Lamme
(B)
An A G van Landeghem
(AAG)
Jeroen W A Leijtens
(JWA)
Mathilde M Leseman-Hoogenboom
(MM)
Manou de Lijster
(M)
Martijn S Marsman
(MS)
Milou H Martens
(MH)
Ilse Masselink
(I)
Wout van der Meij
(W)
Philip Meijnen
(P)
Jarno Melenhorst
(J)
Dietrich J L de Mey
(DJL)
Julia Moelker-Galuzina
(J)
Linda Morsink
(L)
Erik J Mulder
(EJ)
Karin Muller
(K)
Gijsbert D Musters
(GD)
Joost Nederend
(J)
Peter A Neijenhuis
(PA)
Lindsey C F de Nes
(LCF)
M Nielen
(M)
Jan B J van den Nieuwboer
(JBJ)
Jonanne F Nieuwenhuis
(JF)
Joost Nonner
(J)
Bo J Noordman
(BJ)
Stefi Nordkamp
(S)
Pim B Olthof
(PB)
Steven J Oosterling
(SJ)
Daan Ootes
(D)
Vera Oppedijk
(V)
Pieter Ott
(P)
Ida Paulusma
(I)
Koen C M J Peeters
(KCMJ)
Ilona T A Pereboom
(ITA)
Jan Peringa
(J)
Zoë Pironet
(Z)
Joost D J Plate
(JDJ)
Fatih Polat
(F)
Ingrid G M Poodt
(IGM)
Lisanne A E Posma
(LAE)
Jeroen F Prette
(JF)
Bareld B Pultrum
(BB)
Seyed M Qaderi
(SM)
Jan M van Rees
(JM)
Rutger-Jan Renger
(RJ)
Anouk J M Rombouts
(AJM)
Lodewijk Roosen
(L)
Ellen A Roskott-Ten Brinke
(EA)
Joost Rothbarth
(J)
Dennis B Rouw
(DB)
Tom Rozema
(T)
Heidi Rutten
(H)
Harm J T Rutten
(HJT)
Marit E van der Sande
(ME)
Boudewijn E Schaafsma
(BE)
Renske A Schasfoort
(RA)
Merel M Scheurkogel
(MM)
Arjan P Schouten van der Velden
(AP)
Wilhelmina H Schreurs
(WH)
Puck M E Schuivens
(PME)
Colin Sietses
(C)
Petra C G Simons
(PCG)
Marjan J Slob
(MJ)
Gerrit D Slooter
(GD)
Martsje van der Sluis
(M)
Bo P Smalbroek
(BP)
Anke B Smits
(AB)
Ernst J Spillenaar-Bilgen
(EJ)
Patty H Spruit
(PH)
Tanja C Stam
(TC)
Jaap Stoker
(J)
Aaldert K Talsma
(AK)
Sofieke Temmink
(S)
G Y Mireille The
(GYM)
Jeroen A W Tielbeek
(JAW)
Aukje A J M van Tilborg
(AAJM)
Fiek van Tilborg
(F)
Dorothée van Trier
(D)
Jurriaan B Tuynman
(JB)
Maxime J M van der Valk
(MJM)
Inge J S Vanhooymissen
(IJS)
G Boudewijn C Vasbinder
(GBC)
Cornelis J Veeken
(CJ)
Laura A Velema
(LA)
Anthony W H van de Ven
(AWH)
Emiel G G Verdaasdonk
(EGG)
Wouter M Verduin
(WM)
Tim Verhagen
(T)
Paul M Verheijen
(PM)
Maarten Vermaas
(M)
An-Sofie E Verrijssen
(AE)
Anna Vera D Verschuur
(AVD)
Harmke Verwoerd-van Schaik
(HV)
Roy F A Vliegen
(RFA)
Sophie Voets
(S)
F Jeroen Vogelaar
(FJ)
Clementine L A Vogelij
(CLA)
Hanneke A Vos-Westerman
(HA)
Marianne de Vries
(M)
Joy C Vroemen
(JC)
Bas S T van Vugt
(BST)
Johannes A Wegdam
(JA)
Bob J van Wely
(BJ)
Marinke Westerterp
(M)
Paul P van Westerveld
(PP)
Henderik L van Westreenen
(HL)
Allard G Wijma
(AG)
Johannes H W de Wilt
(JHW)
Bart W K de Wit
(BWK)
Fennie Wit
(F)
Karlijn Woensdregt
(K)
Victor van Woerden
(V)
Floor S W van der Wolf
(FSW)
Sander van der Wolk
(S)
Johannes M Wybenga
(JM)
Edwin S van der Zaag
(ES)
Bobby Zamaray
(B)
Herman J A Zandvoort
(HJA)
Dennis van der Zee
(D)
Annette Zeilstra
(A)
Kang J Zheng
(KJ)
David D E Zimmerman
(DDE)
Marcel Zorgdrager
(M)
Informations de copyright
© 2024 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.
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