MRI Predicts Residual Disease and Outcomes in Watch-and-Wait Patients with Rectal Cancer.
Humans
Rectal Neoplasms
/ diagnostic imaging
Female
Male
Middle Aged
Magnetic Resonance Imaging
/ methods
Neoplasm, Residual
/ diagnostic imaging
Watchful Waiting
/ methods
Prospective Studies
Adenocarcinoma
/ diagnostic imaging
Aged
Predictive Value of Tests
Neoadjuvant Therapy
/ methods
Treatment Outcome
Neoplasm Staging
Adult
Journal
Radiology
ISSN: 1527-1315
Titre abrégé: Radiology
Pays: United States
ID NLM: 0401260
Informations de publication
Date de publication:
Sep 2024
Sep 2024
Historique:
medline:
3
9
2024
pubmed:
3
9
2024
entrez:
3
9
2024
Statut:
ppublish
Résumé
Background MRI plays a crucial role in restaging locally advanced rectal cancer treated with total neoadjuvant therapy (TNT); however, prospective studies have not evaluated its ability to accurately select patients for nonoperative management. Purpose To evaluate the ability of restaging MRI to predict oncologic outcomes and identify imaging features associated with residual disease (RD) after TNT. Materials and Methods This was a secondary analysis of the Organ Preservation in Rectal Adenocarcinoma (OPRA) trial, which randomized participants from April 2014 to March 2020 with stages II or III rectal adenocarcinoma to undergo either induction or consolidation TNT. Participants enrolled in the OPRA trial who underwent restaging MRI were eligible for inclusion in the present study. Radiologists classified participants as having clinical complete response (cCR), near-complete clinical response (nCR), or incomplete clinical response (iCR) based on restaging MRI at a mean of 8 weeks ± 4 (SD) after treatment. Oncologic outcomes according to MRI response category were assessed using Kaplan-Meier curves. Logistic regression analysis was performed to identify imaging characteristics associated with RD. Results A total of 277 participants (median age, 58 years [IQR, 17 years]; 179 male) who were randomized in the OPRA trial had restaging MRI forms completed. The median follow-up duration was 4.1 years. Participants with cCR had higher rates of organ preservation compared with those with nCR (65.3% vs 41.6%, log-rank
Identifiants
pubmed: 39225603
doi: 10.1148/radiol.232748
doi:
Banques de données
ClinicalTrials.gov
['NCT02008656']
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
e232748Investigateurs
Sujata Patil
(S)
Jin K Kim
(JK)
Meghan Lee
(M)
Richard F Dunne
(RF)
Jorge Marcet
(J)
Peter Cataldo
(P)
Blase Polite
(B)
Daniel O Herzig
(DO)
David Liska
(D)
Samuel Oommen
(S)
Charles M Friel
(CM)
Charles Ternent
(C)
Andrew L Coveler
(AL)
Steven Hunt
(S)
Anita Gregory
(A)
Madhulika G Varma
(MG)
Brian L Bello
(BL)
Joseph C Carmichael
(JC)
John Krauss
(J)
Ana Gleisner
(A)
Philip B Paty
(PB)
Martin R Weiser
(MR)
Garrett M Nash
(GM)
Emmanouil Pappou
(E)
José G Guillem
(JG)
Larissa Temple
(L)
Iris H Wei
(IH)
Maria Widmar
(M)
Neil H Segal
(NH)
Andrea Cercek
(A)
Rona Yaeger
(R)
J Joshua Smith
(JJ)
Karyn A Goodman
(KA)
Abraham J Wu
(AJ)
Leonard B Saltz
(LB)