Cross-Sectional Study on MRI Restaging After Chemoradiotherapy and Interval to Surgery in Rectal Cancer: Influence on Short- and Long-Term Outcomes

Dutch Snapshot Research Group

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: The time interval between CRT and surgery in rectal cancer patients is still the subject of debate. The aim of this study was to first evaluate the nationwide use of restaging magnetic resonance imaging (MRI) and its impact on timing of surgery, and, second, to evaluate the impact of timing of surgery after chemoradiotherapy (CRT) on short- and long-term outcomes. Methods: Patients were selected from a collaborative rectal cancer research project including 71 Dutch centres, and were subdivided into two groups according to time interval from the start of preoperative CRT to surgery (< 14 and ≥ 14 weeks). Results: From 2095 registered patients, 475 patients received preoperative CRT. MRI restaging was performed in 79.4% of patients, with a median CRT–MRI interval of 10 weeks (interquartile range [IQR] 8–11) and a median MRI–surgery interval of 4 weeks (IQR 2–5). The CRT–surgery interval groups consisted of 224 (< 14 weeks) and 251 patients (≥ 14 weeks), and the long-interval group included a higher proportion of cT4 stage and multivisceral resection patients. Pathological complete response rate (n = 34 [15.2%] vs. n = 47 [18.7%], p = 0.305) and CRM involvement (9.7% vs. 15.9%, p = 0.145) did not significantly differ. Thirty-day surgical complications were similar (20.1% vs. 23.1%, p = 0.943), however no significant differences were found for local and distant recurrence rates, disease-free survival, and overall survival. Conclusions: These real-life data, reflecting routine daily practice in The Netherlands, showed substantial variability in the use and timing of restaging MRI after preoperative CRT for rectal cancer, as well as time interval to surgery. Surgery before or after 14 weeks from the start of CRT resulted in similar short- and long-term outcomes.
Original languageEnglish
Pages (from-to)437-448
JournalAnnals of Surgical Oncology
Volume26
Issue number2
DOIs
Publication statusPublished - 2019

Cite this

@article{531b6f8bbc7b4fd0be58c60cd90729d4,
title = "Cross-Sectional Study on MRI Restaging After Chemoradiotherapy and Interval to Surgery in Rectal Cancer: Influence on Short- and Long-Term Outcomes",
abstract = "Background: The time interval between CRT and surgery in rectal cancer patients is still the subject of debate. The aim of this study was to first evaluate the nationwide use of restaging magnetic resonance imaging (MRI) and its impact on timing of surgery, and, second, to evaluate the impact of timing of surgery after chemoradiotherapy (CRT) on short- and long-term outcomes. Methods: Patients were selected from a collaborative rectal cancer research project including 71 Dutch centres, and were subdivided into two groups according to time interval from the start of preoperative CRT to surgery (< 14 and ≥ 14 weeks). Results: From 2095 registered patients, 475 patients received preoperative CRT. MRI restaging was performed in 79.4{\%} of patients, with a median CRT–MRI interval of 10 weeks (interquartile range [IQR] 8–11) and a median MRI–surgery interval of 4 weeks (IQR 2–5). The CRT–surgery interval groups consisted of 224 (< 14 weeks) and 251 patients (≥ 14 weeks), and the long-interval group included a higher proportion of cT4 stage and multivisceral resection patients. Pathological complete response rate (n = 34 [15.2{\%}] vs. n = 47 [18.7{\%}], p = 0.305) and CRM involvement (9.7{\%} vs. 15.9{\%}, p = 0.145) did not significantly differ. Thirty-day surgical complications were similar (20.1{\%} vs. 23.1{\%}, p = 0.943), however no significant differences were found for local and distant recurrence rates, disease-free survival, and overall survival. Conclusions: These real-life data, reflecting routine daily practice in The Netherlands, showed substantial variability in the use and timing of restaging MRI after preoperative CRT for rectal cancer, as well as time interval to surgery. Surgery before or after 14 weeks from the start of CRT resulted in similar short- and long-term outcomes.",
author = "Robin Detering and Borstlap, {Wernard A. A.} and Lisa Broeders and Linda Hermus and Marijnen, {Corrie A. M.} and Beets-Tan, {Regina G. H.} and Bemelman, {Willem A.} and {van Westreenen}, {Henderik L.} and Tanis, {Pieter J.} and {Dutch Snapshot Research Group} and A. Aalbers and Y. Acherman and Algie, {G. D.} and {von Geusau}, {B. Alting} and F. Amelung and Bartels, {S. A.} and S. Basha and Bastiaansen, {A. J. N. M.} and E. Belgers and W. Bleeker and J. Blok and Boute, {M. C.} and Brinkman, {D. J.} and Buskens, {C. J.} and {de Wilt}, {J. H. W.} and {den Boer}, {F. C.} and A. Demirkiran and Gooszen, {J. A. H.} and Harlaar, {J. J.} and B. Heijnen and P. Hoogland and A. Keijzer and Kool, {M. E.} and Lange, {J. F.} and Musters, {G. D.} and P. Poortman and Reiber, {B. M. M.} and Rutten, {H. J.} and Schreurs, {W. H.} and J. Straatman and C. Sietses and Tuynman, {J. B.} and {van Beek}, {S. C.} and {van de Weijer}, {M. A. J.} and {van der Bilt}, {J. D. W.} and {van der Spek}, A. and {van der Wielen}, N. and {van Rijswijk}, A. and S. Veltkamp and Voeten, {S. C.} and Wouters, {M. W.}",
year = "2019",
doi = "10.1245/s10434-018-07097-7",
language = "English",
volume = "26",
pages = "437--448",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "2",

}

Cross-Sectional Study on MRI Restaging After Chemoradiotherapy and Interval to Surgery in Rectal Cancer: Influence on Short- and Long-Term Outcomes. / Dutch Snapshot Research Group.

In: Annals of Surgical Oncology, Vol. 26, No. 2, 2019, p. 437-448.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Cross-Sectional Study on MRI Restaging After Chemoradiotherapy and Interval to Surgery in Rectal Cancer: Influence on Short- and Long-Term Outcomes

AU - Detering, Robin

AU - Borstlap, Wernard A. A.

AU - Broeders, Lisa

AU - Hermus, Linda

AU - Marijnen, Corrie A. M.

AU - Beets-Tan, Regina G. H.

AU - Bemelman, Willem A.

AU - van Westreenen, Henderik L.

AU - Tanis, Pieter J.

AU - Dutch Snapshot Research Group

AU - Aalbers, A.

AU - Acherman, Y.

AU - Algie, G. D.

AU - von Geusau, B. Alting

AU - Amelung, F.

AU - Bartels, S. A.

AU - Basha, S.

AU - Bastiaansen, A. J. N. M.

AU - Belgers, E.

AU - Bleeker, W.

AU - Blok, J.

AU - Boute, M. C.

AU - Brinkman, D. J.

AU - Buskens, C. J.

AU - de Wilt, J. H. W.

AU - den Boer, F. C.

AU - Demirkiran, A.

AU - Gooszen, J. A. H.

AU - Harlaar, J. J.

AU - Heijnen, B.

AU - Hoogland, P.

AU - Keijzer, A.

AU - Kool, M. E.

AU - Lange, J. F.

AU - Musters, G. D.

AU - Poortman, P.

AU - Reiber, B. M. M.

AU - Rutten, H. J.

AU - Schreurs, W. H.

AU - Straatman, J.

AU - Sietses, C.

AU - Tuynman, J. B.

AU - van Beek, S. C.

AU - van de Weijer, M. A. J.

AU - van der Bilt, J. D. W.

AU - van der Spek, A.

AU - van der Wielen, N.

AU - van Rijswijk, A.

AU - Veltkamp, S.

AU - Voeten, S. C.

AU - Wouters, M. W.

PY - 2019

Y1 - 2019

N2 - Background: The time interval between CRT and surgery in rectal cancer patients is still the subject of debate. The aim of this study was to first evaluate the nationwide use of restaging magnetic resonance imaging (MRI) and its impact on timing of surgery, and, second, to evaluate the impact of timing of surgery after chemoradiotherapy (CRT) on short- and long-term outcomes. Methods: Patients were selected from a collaborative rectal cancer research project including 71 Dutch centres, and were subdivided into two groups according to time interval from the start of preoperative CRT to surgery (< 14 and ≥ 14 weeks). Results: From 2095 registered patients, 475 patients received preoperative CRT. MRI restaging was performed in 79.4% of patients, with a median CRT–MRI interval of 10 weeks (interquartile range [IQR] 8–11) and a median MRI–surgery interval of 4 weeks (IQR 2–5). The CRT–surgery interval groups consisted of 224 (< 14 weeks) and 251 patients (≥ 14 weeks), and the long-interval group included a higher proportion of cT4 stage and multivisceral resection patients. Pathological complete response rate (n = 34 [15.2%] vs. n = 47 [18.7%], p = 0.305) and CRM involvement (9.7% vs. 15.9%, p = 0.145) did not significantly differ. Thirty-day surgical complications were similar (20.1% vs. 23.1%, p = 0.943), however no significant differences were found for local and distant recurrence rates, disease-free survival, and overall survival. Conclusions: These real-life data, reflecting routine daily practice in The Netherlands, showed substantial variability in the use and timing of restaging MRI after preoperative CRT for rectal cancer, as well as time interval to surgery. Surgery before or after 14 weeks from the start of CRT resulted in similar short- and long-term outcomes.

AB - Background: The time interval between CRT and surgery in rectal cancer patients is still the subject of debate. The aim of this study was to first evaluate the nationwide use of restaging magnetic resonance imaging (MRI) and its impact on timing of surgery, and, second, to evaluate the impact of timing of surgery after chemoradiotherapy (CRT) on short- and long-term outcomes. Methods: Patients were selected from a collaborative rectal cancer research project including 71 Dutch centres, and were subdivided into two groups according to time interval from the start of preoperative CRT to surgery (< 14 and ≥ 14 weeks). Results: From 2095 registered patients, 475 patients received preoperative CRT. MRI restaging was performed in 79.4% of patients, with a median CRT–MRI interval of 10 weeks (interquartile range [IQR] 8–11) and a median MRI–surgery interval of 4 weeks (IQR 2–5). The CRT–surgery interval groups consisted of 224 (< 14 weeks) and 251 patients (≥ 14 weeks), and the long-interval group included a higher proportion of cT4 stage and multivisceral resection patients. Pathological complete response rate (n = 34 [15.2%] vs. n = 47 [18.7%], p = 0.305) and CRM involvement (9.7% vs. 15.9%, p = 0.145) did not significantly differ. Thirty-day surgical complications were similar (20.1% vs. 23.1%, p = 0.943), however no significant differences were found for local and distant recurrence rates, disease-free survival, and overall survival. Conclusions: These real-life data, reflecting routine daily practice in The Netherlands, showed substantial variability in the use and timing of restaging MRI after preoperative CRT for rectal cancer, as well as time interval to surgery. Surgery before or after 14 weeks from the start of CRT resulted in similar short- and long-term outcomes.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85058433451&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/30547330

U2 - 10.1245/s10434-018-07097-7

DO - 10.1245/s10434-018-07097-7

M3 - Article

VL - 26

SP - 437

EP - 448

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 2

ER -