. 2019 Feb;26(2):437-448.

doi: 10.1245/s10434-018-07097-7. Epub 2018 Dec 13.

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

Robin Detering¹, Wernard A A Borstlap², Lisa Broeders³, Linda Hermus⁴, Corrie A M Marijnen⁵, Regina G H Beets-Tan⁶, Willem A Bemelman², Henderik L van Westreenen⁷, Pieter J Tanis²; Dutch Snapshot Research Group

Collaborators, Affiliations

Collaborators

Dutch Snapshot Research Group:
A Aalbers, Y Acherman, G D Algie, B Alting von Geusau, F Amelung, S A Bartels, S Basha, A J N M Bastiaansen, E Belgers, W Bleeker, J Blok, R J I Bosker, J W Bosmans, M C Boute, N D Bouvy, H Bouwman, A Brandt-Kerkhof, D J Brinkman, S Bruin, E R J Bruns, J P M Burbach, J W A Burger, C J Buskens, S Clermonts, P P L O Coene, C Compaan, E C J Consten, T Darbyshire, S M L de Mik, E J R de Graaf, I de Groot, R J L de Vos Tot Nederveen Cappel, J H W de Wilt, J van der Wolde, F C den Boer, J W T Dekker, A Demirkiran, M Derkx-Hendriksen, F R Dijkstra, P van Duijvendijk, M S Dunker, Q E Eijsbouts, H Fabry, F Ferenschild, J W Foppen, M F Gerhards, P Gerven, J A H Gooszen, J A Govaert, W M U Van Grevenstein, R Haen, J J Harlaar, E Harst, K Havenga, J Heemskerk, J F Heeren, B Heijnen, P Heres, C Hoff, W Hogendoorn, P Hoogland, A Huijbers, P Janssen, A C Jongen, F H Jonker, E G Karthaus, A Keijzer, J M A Ketel, J Klaase, F W H Kloppenberg, M E Kool, R Kortekaas, P M Kruyt, J T Kuiper, B Lamme, J F Lange, T Lettinga, D J Lips, F Logeman, M F Lutke Holzik, E Madsen, A Mamound, C C Marres, I Masselink, M Meerdink, A G Menon, J S Mieog, D Mierlo, G D Musters, G A P Nieuwenhuijzen, P A Neijenhuis, J Nonner, M Oostdijk, P M P Paul, K C M J Peeters, I T A Pereboom, F Polat, P Poortman, M Raber, B M M Reiber, R J Renger, C C van Rossem, H J Rutten, A Rutten, R Schaapman, M Scheer, L Schoonderwoerd, N Schouten, A M Schreuder, W H Schreurs, G A Simkens, G D Slooter, H C E Sluijmer, N Smakman, R Smeenk, H S Snijders, D J A Sonneveld, B Spaansen, E J Spillenaar Bilgen, E Steller, W H Steup, C Steur, E Stortelder, J Straatman, H A Swank, C Sietses, H A Ten Berge, H G Ten Hoeve, W W Ter Riele, I M Thorensen, B Tip-Pluijm, B R Toorenvliet, L Tseng, J B Tuynman, J van Bastelaar, S C van Beek, A W H van de Ven, M A J van de Weijer, C van den Berg, I van den Bosch, J D W van der Bilt, S J van der Hagen, R van der Hul, G van der Schelling, A van der Spek, N van der Wielen, E van Duyn, C van Eekelen, J A van Essen, K van Gangelt, A A W van Geloven, C van Kessel, Y T van Loon, A van Rijswijk, S J van Rooijen, T van Sprundel, L van Steensel, W F van Tets, H L van Westreenen, S Veltkamp, T Verhaak, P M Verheijen, L Versluis-Ossenwaarde, S Vijfhuize, W J Vles, S C Voeten, F J Vogelaar, W W Vrijland, E Westerduin, M E Westerterp, M Wetzel, K P Wevers, B Wiering, C D M Witjes, M W Wouters, S T K Yauw, E S van der Zaag, E C Zeestraten, D D Zimmerman, T Zwieten

Affiliations

¹ Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. r.detering@amc.uva.nl.
² Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
³ Scientific Bureau of the Dutch Institute of Clinical Auditing, Leiden, The Netherlands.
⁴ Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
⁵ Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands.
⁶ Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
⁷ Department of Surgery, Isala Hospital Zwolle, Zwolle, The Netherlands.

PMID: 30547330
PMCID: PMC6341052
DOI: 10.1245/s10434-018-07097-7

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

Robin Detering et al. Ann Surg Oncol. 2019 Feb.

. 2019 Feb;26(2):437-448.

doi: 10.1245/s10434-018-07097-7. Epub 2018 Dec 13.

Authors

Collaborators

Dutch Snapshot Research Group:
A Aalbers, Y Acherman, G D Algie, B Alting von Geusau, F Amelung, S A Bartels, S Basha, A J N M Bastiaansen, E Belgers, W Bleeker, J Blok, R J I Bosker, J W Bosmans, M C Boute, N D Bouvy, H Bouwman, A Brandt-Kerkhof, D J Brinkman, S Bruin, E R J Bruns, J P M Burbach, J W A Burger, C J Buskens, S Clermonts, P P L O Coene, C Compaan, E C J Consten, T Darbyshire, S M L de Mik, E J R de Graaf, I de Groot, R J L de Vos Tot Nederveen Cappel, J H W de Wilt, J van der Wolde, F C den Boer, J W T Dekker, A Demirkiran, M Derkx-Hendriksen, F R Dijkstra, P van Duijvendijk, M S Dunker, Q E Eijsbouts, H Fabry, F Ferenschild, J W Foppen, M F Gerhards, P Gerven, J A H Gooszen, J A Govaert, W M U Van Grevenstein, R Haen, J J Harlaar, E Harst, K Havenga, J Heemskerk, J F Heeren, B Heijnen, P Heres, C Hoff, W Hogendoorn, P Hoogland, A Huijbers, P Janssen, A C Jongen, F H Jonker, E G Karthaus, A Keijzer, J M A Ketel, J Klaase, F W H Kloppenberg, M E Kool, R Kortekaas, P M Kruyt, J T Kuiper, B Lamme, J F Lange, T Lettinga, D J Lips, F Logeman, M F Lutke Holzik, E Madsen, A Mamound, C C Marres, I Masselink, M Meerdink, A G Menon, J S Mieog, D Mierlo, G D Musters, G A P Nieuwenhuijzen, P A Neijenhuis, J Nonner, M Oostdijk, P M P Paul, K C M J Peeters, I T A Pereboom, F Polat, P Poortman, M Raber, B M M Reiber, R J Renger, C C van Rossem, H J Rutten, A Rutten, R Schaapman, M Scheer, L Schoonderwoerd, N Schouten, A M Schreuder, W H Schreurs, G A Simkens, G D Slooter, H C E Sluijmer, N Smakman, R Smeenk, H S Snijders, D J A Sonneveld, B Spaansen, E J Spillenaar Bilgen, E Steller, W H Steup, C Steur, E Stortelder, J Straatman, H A Swank, C Sietses, H A Ten Berge, H G Ten Hoeve, W W Ter Riele, I M Thorensen, B Tip-Pluijm, B R Toorenvliet, L Tseng, J B Tuynman, J van Bastelaar, S C van Beek, A W H van de Ven, M A J van de Weijer, C van den Berg, I van den Bosch, J D W van der Bilt, S J van der Hagen, R van der Hul, G van der Schelling, A van der Spek, N van der Wielen, E van Duyn, C van Eekelen, J A van Essen, K van Gangelt, A A W van Geloven, C van Kessel, Y T van Loon, A van Rijswijk, S J van Rooijen, T van Sprundel, L van Steensel, W F van Tets, H L van Westreenen, S Veltkamp, T Verhaak, P M Verheijen, L Versluis-Ossenwaarde, S Vijfhuize, W J Vles, S C Voeten, F J Vogelaar, W W Vrijland, E Westerduin, M E Westerterp, M Wetzel, K P Wevers, B Wiering, C D M Witjes, M W Wouters, S T K Yauw, E S van der Zaag, E C Zeestraten, D D Zimmerman, T Zwieten

Affiliations

¹ Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. r.detering@amc.uva.nl.
² Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
³ Scientific Bureau of the Dutch Institute of Clinical Auditing, Leiden, The Netherlands.
⁴ Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands.
⁵ Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands.
⁶ Department of Radiology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
⁷ Department of Surgery, Isala Hospital Zwolle, Zwolle, The Netherlands.

PMID: 30547330
PMCID: PMC6341052
DOI: 10.1245/s10434-018-07097-7

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.

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Figures

**Fig. 1**
Number of patients for each chemoradiotherapy-surgery time interval in weeks from start of chemoradiotherapy

**Fig. 2**
Kaplan–Meier of local recurrence, distant recurrence, disease-free survival and overall survival in short- and long interval group

See this image and copyright information in PMC

Comment in

ASO Author Reflections: Similar Short- and Long-Term Outcomes in Variable Use and Timing of Restaging MRI and Surgery After Preoperative Chemoradiotherapy for Rectal Cancer.
Detering R, Tanis PJ. Detering R, et al. Ann Surg Oncol. 2019 Dec;26(Suppl 3):577-578. doi: 10.1245/s10434-019-07286-y. Epub 2019 Mar 7. Ann Surg Oncol. 2019. PMID: 30847749 Free PMC article. No abstract available.

References

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1. Du D, Su Z, Wang D, et al. Optimal interval to surgery after neoadjuvant chemoradiotherapy in rectal cancer: a systematic review and meta-analysis. Clin Colorectal Cancer. 2018;17(1):13–24. doi: 10.1016/j.clcc.2017.10.012. - DOI - PubMed
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Cross-Sectional Study on MRI Restaging After Chemoradiotherapy and Interval to Surgery in Rectal Cancer: Influence on Short- and Long-Term Outcomes

Collaborators

Affiliations

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

Authors

Collaborators

Affiliations

Abstract

Figures

Comment in

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Research Materials