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1. Progressive plasticity during colorectal cancer metastasis

Author

Moorman, A. R., Benitez, E. K., Cambuli, F., Jiang, Q., Mahmoud, A., Lumish, M., Hartner, S., Balkaran, S., Bermeo, J., Asawa, S., Firat, C., Saxena, A., Wu, F., Luthra, A., Burdziak, C., Xie, Y., Sgambati, V., Luckett, K., Li, Y., Yi, Z., Masilionis, I., Soares, K., Pappou, E., Yaeger, R., Kingham, P., Jarnagin, W., Paty, P., Weiser, M. R., Mazutis, L., D’Angelica, M., Shia, J., Garcia-Aguilar, J., Nawy, T., Hollmann, T. J., Chaligné, R., Sanchez-Vega, F., Sharma, R., Pe’er, D., and Ganesh, K.

Published
2024
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2. Soft breaking of the $\mu\leftrightarrow \tau$ symmetry by $\mathbf{S}_{4}\otimes \mathbf{Z}_{2}$

Author

García-Aguilar, J. D., Ramírez, Asahel Enrique Pozas, Castañeda, Marlon Michael Suárez, and Gómez-Izquierdo, Juan Carlos

Subjects
High Energy Physics - Phenomenology
Abstract

The $\mu \leftrightarrow \tau$ symmetry has been ruled out by its predictions on the reactor and atmospheric angles, nevertheless, a breaking of this symmetry might provide correct values. For that reason, we build a non-renormalizable lepton model where the mixings arise from the spontaneous breaking of the $\mathbf{S}_{4}\otimes \mathbf{Z}_{2}$ discrete group, subsequently the $\mu \leftrightarrow \tau$ symmetry is broken in the effective neutrino mass matrix, that comes from the type II see-saw mechanism. As main result, the reactor and atmospheric angles are corrected and their values are in good agreement with the experimental data for the inverted hierarchy. Furthermore, we point out a link between the atmospheric angle and reactor one. In the quark sector, under certain assumptions, the generalized Fritzsch textures shape to the quark mass matrices so that the CKM matrix values are guaranteed., Comment: 19 pages, 6 figures. Minor changes, accepted in Revista Mexicana de F\'isica

Published
2022
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3. Organ preservation after neoadjuvant long-course chemoradiotherapy versus short-course radiotherapy

Author

Bercz, A., Park, B.K., Pappou, E., Nemirovsky, D., Sarkar, R., Yamner, M., Omer, D., Verheij, F.S., Alvarez, J., Atri, P., Reyngold, M., Yaeger, R., Wei, I.H., Wu, A., Raj, N., Widmar, M., Hajj, C., Kim, M.J., Rao, D., Nash, G.M., Williams, V., Shia, J., Segal, N.H., Diaz, L., Ganesh, K., Weiser, M.R., Gollub, M.J., Paty, P.B., Horvat, N., Zinovoy, M., Roth O’Brien, D., Sanchez-Vega, F., Saltz, L.B., Crane, C.H., Cercek, A., Gonen, M., Garcia-Aguilar, J., Smith, J.J., and Romesser, P.B.

Published
2024
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4. Estandarización de la definición de los tipos de colectomía oncológica. Método Delphi para consenso de expertos de la Asociación Española de Cirujanos

Author

Die-Trill, J., Pascual Damieta, P., Peña Ros, E., Jimenez Rodríguez, R., Hidalgo Pujol, M., Jiménez Gómez, L.M., Arencibia Pérez, B., Vigorita, V., Colombari, R., Pérez Pérez, T., García Martínez, M.T., Bauxali, J., Cerdán, J., García-Pérez, J.C., Martin-Perez, B., Uribe Quintana, N., Farrés Coll, R., González-Argenté, F.J., Bernal Sprekelsen, J.C., Fraccalvieri, D., Garcia Granero, E., Gómez Ruiz, M., García Cabrera, A.M., Palma, P., Pla-Martí, V., Mera Velasco, S., Blanco-Antona, F., Parajó, A., Salgado, G., Vázquez Monchul, J.M., Ocaña Jiménez, J., Jiménez-Escobar, F., Martí-Gallostra, M., Díaz Pavón, J.M., Salvador-Morales, C., Biondo, S., Espí, A., Solana-Bueno, A., Marín, G., Pastor Idoate, C., Valle-Hernández, E.D., Tejedor, P., Alós Company, R., Elosua, T., Rueda Orgaz, J.A., García Septiem, J., Ballester Ibánez, C., Frasson, M., Hernandis Villalba, J.V., Pascual Miguelañez, I., García-González, J.M., Jimenez-Toscano, M., Benavides Buleje, J.A., Enríquez-Navascués, J.M., Reyes Díaz, M.L., Millan, M., Sánchez-Guillén, L., Roig Vila, J.V., Parra-Baños, P.A., Fernánde, C., Cantero-Cid, R., Truán Alonso, N., Nogués-Ramia, E.M., Serra Pla, S., Climent-Agustín, M., Marinello, F., Moro-Valdezate, D., Frago, R., Espin, E., Pera-Román, M., Álvarez Laso, C.J., Placer-Galan, C., Labalde Martínez, M., García-Armengol, J.J., Codina, A., Capitan-Morales, L.C., Garcia-Aguilar, J., Fernández-Cebrián, J.M., Fernández-Hevia, M., García-Flórez, L.J., Pellino, G., Martínez-Pérez, C., Fernández-López, F., Garcia-Granero, Alvaro, Martín-Martín, Gonzalo P, Dujovne-Lindenbaum, Paula, Alvarez Laso, Carlos J, Cerdán-Santacruz, Carlos, Flor-Lorente, Blas, and Biondo, Sebastiano

Published
2024
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5. Standardization of the definition of the types of oncological colectomy. Delphi method for consensus of experts of the Spanish Association of Surgeons

Author

Die-Trill, J., Pascual Damieta, P., Peña Ros, E., Jimenez Rodríguez, R., Hidalgo Pujol, M., Jiménez Gómez, L.M., Arencibia Pérez, B., Vigorita, V., Colombari, R., Pérez Pérez, T., García Martínez, M.T., Bauxali, J., Cerdán, J., García-Pérez, J.C., Martin-Perez, B., Uribe Quintana, N., Farrés Coll, R., González-Argenté, F.J., Bernal Sprekelsen, J.C., Fraccalvieri, D., Garcia Granero, E., Gómez Ruiz, M., García Cabrera, A.M., Palma, P., Pla-Martí, V., Mera Velasco, S., Blanco-Antona, F., Parajó, A., Salgado, G., Vázquez Monchul, J.M., Ocaña Jiménez, J., Jiménez-Escobar, F., Martí-Gallostra, M., Díaz Pavón, J.M., Salvador-Morales, C., Biondo, S., Espí, A., Solana-Bueno, A., Marín, G., Pastor Idoate, C., Valle-Hernández, E.D., Tejedor, P., Alós Company, R., Elosua, T., Rueda Orgaz, J.A., García Septiem, J., Ballester Ibánez, C., Frasson, M., Hernandis Villalba, J.V., Pascual Miguelañez, I., García-González, J.M., Jimenez-Toscano, M., Benavides Buleje, J.A., Enríquez-Navascués, J.M., Reyes Díaz, M.L., Millan, M., Sánchez-Guillén, L., Roig Vila, J.V., Parra-Baños, P.A., Fernánde, C., Cantero-Cid, R., Truán Alonso, N., Nogués-Ramia, E.M., Serra Pla, S., Climent-Agustín, M., Marinello, F., Moro-Valdezate, D., Frago, R., Espin, E., Pera-Román, M., Álvarez Laso, C.J., Placer-Galan, C., Labalde Martínez, M., García-Armengol, J.J., Codina, A., Capitan-Morales, L.C., Garcia-Aguilar, J., Fernández-Cebrián, J.M., Fernández-Hevia, M., García-Flórez, L.J., Pellino, G., Martínez-Pérez, C., Fernández-López, F., Garcia-Granero, Alvaro, Martín-Martín, Gonzalo P., Dujovne-Lindenbaum, Paula, Alvarez Laso, Carlos J., Cerdán-Santacruz, Carlos, Flor-Lorente, Blas, and Biondo, Sebastiano

Published
2024
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6. A non-renormalizable neutrino mass model with $\mathbf{S}_{3}\otimes \mathbf{Z}_{2}$ symmetry

Author

García-Aguilar, J. D. and Gómez-Izquierdo, Juan Carlos

Subjects
High Energy Physics - Phenomenology, High Energy Physics - Theory
Abstract

The lepton sector is studied within a flavored non-renormalizable model where the $\mathbf{S}_{3}\otimes \mathbf{Z}_{2}$ flavor symmetry drives the Yukawa couplings. In this framework, the effective neutrino mass, that comes from the type II see-saw mechanism, as well as the charged lepton mass matrices are hierarchical and possessed (under a benchmark in the charged sector) a kind of Fritzsch textures that achieve to accommodate the mixing angles in good agreement with the last experimental data. The model predicts a CP-violating phase consistent with the experimental data and the branching ratio for the lepton flavor violation process, $\mu\rightarrow e\gamma$, is well below the current bound., Comment: Extended discussion and we add one additional figure. arXiv admin note: substantial text overlap with arXiv:2010.15370

Published
2021
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7. Effects of a background scalar field induced by the Lorentz symmetry violation on Non Relativistic Quantum Mechanics

Author

García-Aguilar, J. D.

Subjects
Quantum Physics, High Energy Physics - Phenomenology
Abstract

The extension of Standard Model of the Fundamental Particles which consider the Lorentz Symmetry Violation governed by a background tensor field presented by Colladay and Kostelecky consider the hypothesis of having a privileged direction in the space-time. Here we investigated a extension of the Schr\"odinger Equation inspired on that model taking into account a background scalar field. We analyze the behavior of this modified Schr\"odinger equation on a particle trapped in a well and quantum harmonic oscillator., Comment: 7 pages, 3 figures

Published
2021

8. C\'alculo de la integral escalar a un lazo $A(m^2)$ mediante el teorema del residuo

Author

García-Aguilar, J. D. and Gómez-Izquierdo, J. C.

Subjects
High Energy Physics - Phenomenology
Abstract

Radiative corrections in the phenomenology of particle physics lead to great predictions on the observables of the Standard Model (SM) which are in good agreement with different measurements on Particle Accelerators and Detectors and in the case of numeric predictions on Quantum Chromodynamics (QCD) and its study in the lattice for the low energy regime. This is a pedagogical paper in which we calculate the one loop scalar integral $A(m^2)$, that arises in the simplest radiative correction calculation, by means of the dimensional regularization. As main result, we perform also the evaluation of this integral by using the Residue Theorem on complex variable. In addition, the equivalence between the two procedures is shown through Gamma function properties., Comment: in Spanish

Published
2020
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9. Flavored multiscalar $\mathbf{S}_{3}$ model with normal hierarchy neutrino mass

Author

García-Aguilar, J. D. and Gómez-Izquierdo, Juan Carlos

Subjects
High Energy Physics - Phenomenology
Abstract

We construct a multiscalar and non-renormalizable model where the $\mathbf{S}_{3}$ flavor symmetry drives mainly the Yukawa couplings. In the quark sector, the Nearest Neighbor Interaction (NNI) textures are behind the CKM mixing matrix so that this is fitted in good agreement with the last available results. In the lepton sector, an almost diagonal charged lepton mass matrix and extended Fritzsch mass textures in the effective neutrino mass matrix, that comes from the type II see-saw mechanism, provide consistent values for the mixing angles where the normal hierarchy is favored. The model predicts a CP-violating phase consistent with the experimental data and the BR for the lepton flavor violation process, $\mu\rightarrow e\gamma$, is well below the current bound., Comment: Some references added

Published
2020

10. A comparative study between the modified Fritzsch and nearest neighbor interaction textures

Author

García-Aguilar, J. D. and Gómez-Izquierdo, Juan Carlos

Subjects
High Energy Physics - Phenomenology
Abstract

From mass textures point of view, we present a comparative study of the $\mathbf{S}_{3}$ flavor symmetry in the left-right symmetry model (LRSM) and the baryon minus lepton model (BLM) taking into account their predictions on the CKM mixing matrix. To do this, we recover the already studied quark mass matrix, that comes from some published papers, and under certain strong assumption, one can show that there are predictive scenarios in the LRSM and BLM where the modified Fritzsch and nearest neighbor interaction (NNI) textures drive respectively the quark mixings. As main result, the CKM mixing matrix is in good agreement with the last experimental data in the flavored BLM model., Comment: 15 pages, 8 figures. Minor chances, references and some comments added

Published
2019
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11. Programme of self-reactive innate-like T cell-mediated cancer immunity

Author

Chou, Chun, Zhang, Xian, Krishna, Chirag, Nixon, Briana G., Dadi, Saida, Capistrano, Kristelle J., Kansler, Emily R., Steele, Miranda, Han, Jian, Shyu, Amy, Zhang, Jing, Stamatiades, Efstathios G., Liu, Ming, Li, Shun, Do, Mytrang H., Edwards, Chaucie, Kang, Davina S., Chen, Chin-Tung, Wei, Iris H., Pappou, Emmanouil P., Weiser, Martin R., Garcia-Aguilar, J., Smith, J. Joshua, Leslie, Christina S., and Li, Ming O.

Published
2022
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13. Implications of Lorentz symmetry violation on a 5D supersymmetric model

Author

García-Aguilar, J. D. and Pérez-Lorenzana, A.

Subjects
High Energy Physics - Theory
Abstract

Field models with $n$ extra spatial dimensions have a larger $SO(1,3+n)$ Lorentz symmetry which is broken down to the standard $SO(1,3)$ four dimensional one by the compactification process. By considering Lorentz violating operators in a $5D$ supersymmetric Wess-Zumino mo\-del, which otherwise conserve the standard four dimensional Poincare invariance, we show that supersymmetry can be restored upon a simple deformation of the supersymmetric transformations. However, supersymmetry is not preserved in the effective $4D$ theory that arises after compactification when the $5D$ Lorentz violating operators do not preserve $Z_2: y\rightarrow -y$ bulk parity. Our mechanism unveils a possible connection among Lorentz violation and the Scherk-Schwarz mechanism. We also show that parity preserving models, on the other hand, do provide well defined supersymmetric KK models., Comment: Some discussion and references added

Published
2016
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14. Estandarización de la definición de los tipos de colectomía oncológica. Método Delphi para consenso de expertos de la Asociación Española de Cirujanos

Author

Garcia-Granero, Alvaro, Martín-Martín, Gonzalo P, Dujovne-Lindenbaum, Paula, Alvarez Laso, Carlos J, Cerdán-Santacruz, Carlos, Flor-Lorente, Blas, Biondo, Sebastiano, Die-Trill, J., Pascual Damieta, P., Peña Ros, E., Jimenez Rodríguez, R., Hidalgo Pujol, M., Jiménez Gómez, L.M., Arencibia Pérez, B., Vigorita, V., Colombari, R., Pérez Pérez, T., García Martínez, M.T., Bauxali, J., Cerdán, J., García-Pérez, J.C., Martin-Perez, B., Uribe Quintana, N., Farrés Coll, R., González-Argenté, F.J., Bernal Sprekelsen, J.C., Fraccalvieri, D., Garcia Granero, E., Gómez Ruiz, M., García Cabrera, A.M., Palma, P., Pla-Martí, V., Mera Velasco, S., Blanco-Antona, F., Parajó, A., Salgado, G., Vázquez Monchul, J.M., Ocaña Jiménez, J., Jiménez-Escobar, F., Martí-Gallostra, M., Díaz Pavón, J.M., Salvador-Morales, C., Biondo, S., Espí, A., Solana-Bueno, A., Marín, G., Pastor Idoate, C., Valle-Hernández, E.D., Tejedor, P., Alós Company, R., Elosua, T., Rueda Orgaz, J.A., García Septiem, J., Ballester Ibánez, C., Frasson, M., Hernandis Villalba, J.V., Pascual Miguelañez, I., García-González, J.M., Jimenez-Toscano, M., Benavides Buleje, J.A., Enríquez-Navascués, J.M., Reyes Díaz, M.L., Millan, M., Sánchez-Guillén, L., Roig Vila, J.V., Parra-Baños, P.A., Fernánde, C., Cantero-Cid, R., Truán Alonso, N., Nogués-Ramia, E.M., Serra Pla, S., Climent-Agustín, M., Marinello, F., Moro-Valdezate, D., Frago, R., Espin, E., Pera-Román, M., Álvarez Laso, C.J., Placer-Galan, C., Labalde Martínez, M., García-Armengol, J.J., Codina, A., Capitan-Morales, L.C., Garcia-Aguilar, J., Fernández-Cebrián, J.M., Fernández-Hevia, M., García-Flórez, L.J., Pellino, G., Martínez-Pérez, C., and Fernández-López, F.

Abstract

[Display omitted]

Published
2024
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16. The role of radiative corrections on an extradimensional SUSY model

Author

García-Aguilar, J. D. and Pérez-Lorenzana, A.

Subjects
High Energy Physics - Theory, High Energy Physics - Phenomenology
Abstract

Theories with extra-dimensional coordinates provide interesting mechanisms to achieve the rupture of symmetries. Here we present a novel alternative to the usual geometric considerations to achieve supersymmetric breaking for an extra-dimensional Wess-Zumino model. A supersymmetric model is constructed where the superpotential contains an effective supersymmetric non renormalizable operator, which generates, after compactification, the explicitly rupture of supersymmetry for the excited Kaluza-Klein excitations. The supersymmetry breaking is, in turn, communicated, by the radiatives corrections, to the zero mode.

Published
2014

22. Current controversies in TNM for the radiological staging of rectal cancer and how to deal with them: results of a global online survey and multidisciplinary expert consensus

Author

Lambregts, D.M.J., Bogveradze, N., Blomqvist, L.K., Fokas, E., Garcia-Aguilar, J., Glimelius, B., Gollub, M.J., Konishi, T., Marijnen, C.A., Nagtegaal, I.D., Nilsson, P.J., Perez, R.O., Snaebjornsson, P., Taylor, S.A., Tolan, D.J.M., Valentini, V., West, N.P., Wolthuis, A., Lahaye, M.J., Maas, M. van der, Beets, G.L., Beets-Tan, R.G., Lambregts, D.M.J., Bogveradze, N., Blomqvist, L.K., Fokas, E., Garcia-Aguilar, J., Glimelius, B., Gollub, M.J., Konishi, T., Marijnen, C.A., Nagtegaal, I.D., Nilsson, P.J., Perez, R.O., Snaebjornsson, P., Taylor, S.A., Tolan, D.J.M., Valentini, V., West, N.P., Wolthuis, A., Lahaye, M.J., Maas, M. van der, Beets, G.L., and Beets-Tan, R.G.

Abstract

Contains fulltext : 252069.pdf (Publisher’s version ) (Open Access), OBJECTIVES: To identify the main problem areas in the applicability of the current TNM staging system (8(th) ed.) for the radiological staging and reporting of rectal cancer and provide practice recommendations on how to handle them. METHODS: A global case-based online survey was conducted including 41 image-based rectal cancer cases focusing on various items included in the TNM system. Cases reaching < 80% agreement among survey respondents were identified as problem areas and discussed among an international expert panel, including 5 radiologists, 6 colorectal surgeons, 4 radiation oncologists, and 3 pathologists. RESULTS: Three hundred twenty-one respondents (from 32 countries) completed the survey. Sixteen problem areas were identified, related to cT staging in low-rectal cancers, definitions for cT4b and cM1a disease, definitions for mesorectal fascia (MRF) involvement, evaluation of lymph nodes versus tumor deposits, and staging of lateral lymph nodes. The expert panel recommended strategies on how to handle these, including advice on cT-stage categorization in case of involvement of different layers of the anal canal, specifications on which structures to include in the definition of cT4b disease, how to define MRF involvement by the primary tumor and other tumor-bearing structures, how to differentiate and report lymph nodes and tumor deposits on MRI, and how to anatomically localize and stage lateral lymph nodes. CONCLUSIONS: The recommendations derived from this global survey and expert panel discussion may serve as a practice guide and support tool for radiologists (and other clinicians) involved in the staging of rectal cancer and may contribute to improved consistency in radiological staging and reporting. KEY POINTS: • Via a case-based online survey (incl. 321 respondents from 32 countries), we identified 16 problem areas related to the applicability of the TNM staging system for the radiological staging and reporting of rectal cancer. • A multidiscipl

Published
2022

25. Feasibility of Organ Preservation With Short Course Radiation Therapy as Part of Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer During the COVID-19 Pandemic

Author

Sarkar, R.R., primary, Wu, A.J., additional, Reyngold, M., additional, Cuaron, J.J., additional, Zinovoy, M., additional, Hajj, C., additional, Pappou, E., additional, Segal, N., additional, Yaeger, R., additional, Wei, I.H., additional, Widmar, M., additional, Weiser, M., additional, Paty, P., additional, Cercek, A., additional, Smith, J.J., additional, Saltz, L., additional, Garcia-Aguilar, J., additional, Crane, C.H., additional, and Romesser, P.B., additional

Published
2021
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26. Prevalence of nodal involvement in rectal cancer after chemoradiotherapy

Author

Haak, H E, primary, Beets, G L, additional, Peeters, K, additional, Nelemans, P J, additional, Valentini, V, additional, Rödel, C, additional, Kuo, L, additional, Calvo, F A, additional, Garcia-Aguilar, J, additional, Glynne-Jones, R, additional, Pucciarelli, S, additional, Suarez, J, additional, Theodoropoulos, G, additional, Biondo, S, additional, Lambregts, D M J, additional, Beets-Tan, R G H, additional, and Maas, M, additional

Published
2021
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27. International consensus recommendations on key outcome measures for organ preservation after (chemo)radiotherapy in patients with rectal cancer

Author

Fokas, E., Fokas, E., Appelt, A., Glynne-Jones, R., Beets, G., Perez, R., Garcia-Aguilar, J., Rullier, E., Smith, J.J., Marijnen, C., Peters, F.P., van der Valk, M., Beets-Tan, R., Myint, A.S., Gerard, J.P., Bach, S.P., Ghadimi, M., Hofheinz, R.D., Bujko, K., Gani, C., Haustermans, K., Minsky, B.D., Ludmir, E., West, N.P., Gambacorta, M.A., Valentini, V., Buyse, M., Renehan, A.G., Gilbert, A., Sebag-Montefiore, D., Rodel, C., Fokas, E., Fokas, E., Appelt, A., Glynne-Jones, R., Beets, G., Perez, R., Garcia-Aguilar, J., Rullier, E., Smith, J.J., Marijnen, C., Peters, F.P., van der Valk, M., Beets-Tan, R., Myint, A.S., Gerard, J.P., Bach, S.P., Ghadimi, M., Hofheinz, R.D., Bujko, K., Gani, C., Haustermans, K., Minsky, B.D., Ludmir, E., West, N.P., Gambacorta, M.A., Valentini, V., Buyse, M., Renehan, A.G., Gilbert, A., Sebag-Montefiore, D., and Rodel, C.

Abstract

Multimodal treatment strategies for patients with rectal cancer are increasingly including the possibility of organ preservation, through nonoperative management or local excision. Organ preservation strategies can enable patients with a complete response or near-complete clinical responses after radiotherapy with or without concomitant chemotherapy to safely avoid the morbidities associated with radical surgery, and thus to maintain anorectal function and quality of life. However, standardization of the key outcome measures of organ preservation strategies is currently lacking; this includes a lack of consensus of the optimal definitions and selection of primary end points according to the trial phase and design; the optimal time points for response assessment; response-based decision-making; follow-up schedules; use of specific anorectal function tests; and quality of life and patient-reported outcomes. Thus, a consensus statement on outcome measures is necessary to ensure consistency and facilitate more accurate comparisons of data from ongoing and future trials. Here, we have convened an international group of experts with extensive experience in the management of patients with rectal cancer, including organ preservation approaches, and used a Delphi process to establish the first international consensus recommendations for key outcome measures of organ preservation, in an attempt to standardize the reporting of data from both trials and routine practice in this emerging area.Patients with early-stage rectal cancer might potentially benefit from treatment with an organ-sparing approach, which preserves quality of life owing to avoidance of the need for permanent colostomy. Trials conducted to investigate this have so far been hampered by considerable inter-trial heterogeneity in several key features. In this Consensus Statement, the authors provide guidance on the optimal end points, response assessment time points, follow-up procedures and quality of life measu

Published
2021

28. Rectal cancer lateral lymph nodes: multicentre study of the impact of obturator and internal iliac nodes on oncological outcomes

Author

Schaap, D.P., Schaap, D.P., Boogerd, L.S.F., Konishi, T., Cunningham, C., Ogura, A., Garcia-Aguilar, J., Beets, G.L., Suzuki, C., Toda, S., Lee, I.K., Sammour, T., Uehara, K., Lee, P., Tuynman, J.B., van de Velde, C.J.H., Rutten, H.J.T., Kusters, M., Lateral Node Study Consortium, Schaap, D.P., Schaap, D.P., Boogerd, L.S.F., Konishi, T., Cunningham, C., Ogura, A., Garcia-Aguilar, J., Beets, G.L., Suzuki, C., Toda, S., Lee, I.K., Sammour, T., Uehara, K., Lee, P., Tuynman, J.B., van de Velde, C.J.H., Rutten, H.J.T., Kusters, M., and Lateral Node Study Consortium

Abstract

Background: In patients with rectal cancer, enlarged lateral lymph nodes (LLNs) result in increased lateral local recurrence (LLR) and lower cancer-specific survival (CSS) rates, which can be improved with (chemo)radiotherapy ((C)RT) and LLN dissection (LLND). This study investigated whether different LLN locations affect oncological outcomes.Methods: Patients with low cT3-4 rectal cancer without synchronous distant metastases were included in this multicentre retrospective cohort study. All MRI was re-evaluated, with special attention to LLN involvement and response.Results: More advanced cT and cN category were associated with the occurrence of enlarged obturator nodes. Multivariable analyses showed that a node in the internal iliac compartment with a short-axis (SA) size of at least 7 mm on baseline MRI and over 4 mm after (C)RT was predictive of LLR, compared with a post-(C)RT SA of 4 mm or less (hazard ratio (HR) 5.74, 95 per cent c.i. 2.98 to 11.05 us HR 1.40, 0.19 to 10.20; P < 0.001). Obturator LLNs with a SA larger than 6 mm after (C)RT were associated with a higher 5-year distant metastasis rate and lowered CSS in patients who did not undergo LLND. The survival difference was not present after LLND. Multivariable analyses found that only cT category (HR 2.22, 1.07 to 4.64; P = 0.033) and margin involvement (HR 2.95, 1.18 to 7.37; P = 0.021) independently predicted the development of metastatic disease.Conclusion: Internal iliac LLN enlargement is associated with an increased LLR rate, whereas obturator nodes are associated with more advanced disease with increased distant metastasis and reduced CSS rates. LLND improves local control in persistent internal iliac nodes, and might have a role in controlling systemic spread in persistent obturator nodes.Members of the Lateral Node Study Consortium are co-authors of this study and are listed under the heading Collaborators.

Published
2021

29. Prevalence of nodal involvement in rectal cancer after chemoradiotherapy

Author

Haak, H.E., Haak, H.E., Beets, G.L., Peeters, K., Nelemans, P.J., Valentini, V., Rodel, C., Kuo, L., Calvo, F.A., Garcia-Aguilar, J., Glynne-Jones, R., Pucciarelli, S., Suarez, J., Theodoropoulos, G., Biondo, S., Lambregts, D.M.J., Beets-Tan, R.G.H., Maas, M., Haak, H.E., Haak, H.E., Beets, G.L., Peeters, K., Nelemans, P.J., Valentini, V., Rodel, C., Kuo, L., Calvo, F.A., Garcia-Aguilar, J., Glynne-Jones, R., Pucciarelli, S., Suarez, J., Theodoropoulos, G., Biondo, S., Lambregts, D.M.J., Beets-Tan, R.G.H., and Maas, M.

Abstract

Background: The purpose of this study was to investigate the prevalence of ypN+ status according to ypT category in patients with locally advanced rectal cancer treated with chemoradiotherapy and total mesorectal excision, and to assess the impact of ypN+ on disease recurrence and survival by pooled analysis of individual-patient data.Methods: Individual-patient data from 10 studies of chemoradiotherapy for rectal cancer were included. Pooled rates of ypN+ disease were calculated with 95 per cent confidence interval for each ypT category. Kaplan-Meier and Cox regression analyses were undertaken to assess influence of ypN status on 5-year disease-free survival (DFS) and overall survival (OS).Results: Data on 1898 patients were included in the study. Median follow-up was 50 (range 0-219)months. The pooled rate of ypN+ disease was 7 per cent for ypT0, 12 per cent for ypT1, 17 per cent for ypT2, 40 per cent for ypT3, and 46 per cent for ypT4 tumours. Patients with ypN+ disease had lower 5-year DFS and OS (46.2 and 63.4 per cent respectively) than patients with ypN0 tumours (74.5 and 83.2 per cent) (P<0.001). Cox regression analyses showed ypN+ status to be an independent predictor of recurrence and death.Conclusion: Risk of nodal metastases (ypN+) after chemoradiotherapy increases with advancing ypT category and needs to be considered if an organ-preserving strategy is contemplated.Lay SummaryWhen patients are diagnosed with rectal cancer and the tumour grows beyond the rectal wall there is a high risk that the tumour has spread to nearby lymph nodes. This study showed that this relationship between tumour invasion depth and lymph node involvement is similar after treatment with (chemo)radiotherapy. Patients who have tumour cells remaining in the lymph nodes after (chemo) radiotherapy have a worse prognosis than patients who do not have cancer cells remaining in the lymph nodes. When an organ-preserving treatment is considered as an alternative therapy, this should b

Published
2021

31. Outcome measures in multimodal rectal cancer trials

Author

Fokas, E., Glynne-Jones, R., Appelt, A., Beets-Tan, R., Beets, G., Haustermans, K., Marijnen, C., Minsky, B. D., Ludmir, E., Quirke, P., Sebag-Montefiore, D., Garcia-Aguilar, J., Gambacorta, M. A., Valentini, V., Buyse, M., Rodel, C., Gambacorta M. A. (ORCID:0000-0001-5455-8737), Valentini V. (ORCID:0000-0003-4637-6487), Fokas, E., Glynne-Jones, R., Appelt, A., Beets-Tan, R., Beets, G., Haustermans, K., Marijnen, C., Minsky, B. D., Ludmir, E., Quirke, P., Sebag-Montefiore, D., Garcia-Aguilar, J., Gambacorta, M. A., Valentini, V., Buyse, M., Rodel, C., Gambacorta M. A. (ORCID:0000-0001-5455-8737), and Valentini V. (ORCID:0000-0003-4637-6487)

Abstract

There is a large variability regarding the definition and choice of primary endpoints in phase 2 and phase 3 multimodal rectal cancer trials, resulting in inconsistency and difficulty of data interpretation. Also, surrogate properties of early and intermediate endpoints have not been systematically assessed. We provide a comprehensive review of clinical and surrogate endpoints used in trials for non-metastatic rectal cancer. The applicability, advantages, and disadvantages of these endpoints are summarised, with recommendations on clinical endpoints for the different phase trials, including limited surgery or non-operative management for organ preservation. We discuss how early and intermediate endpoints, including patient-reported outcomes and involvement of patients in decision making, can be used to guide trial design and facilitate consistency in reporting trial results in rectal cancer.

Published
2020

32. Definitive Intensity-Modulated Radiation Therapy For Anal Squamous Cell Carcinoma: Outcomes And Toxicities From A Large Single Institution Experience

Author

Hristidis, V., primary, Chakrani, Z., additional, Cuaron, J.J., additional, Reyngold, M., additional, Zinovoy, M., additional, Hajj, C., additional, El Dika, I., additional, Pappou, E., additional, Tuli, R., additional, Connell, L., additional, Yaeger, R., additional, Smith, J.J., additional, Saltz, L., additional, Shia, J., additional, Gollub, M., additional, Weiser, M., additional, Garcia-Aguilar, J., additional, Wu, A.J., additional, Cercek, A., additional, Crane, C.H., additional, and Romesser, P.B., additional

Published
2020
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33. Definitive Intent Locoregional IMRT In Oligometastatic Anal Squamous Cell Carcinoma

Author

Chakrani, Z., primary, Hristidis, V., additional, Reyngold, M., additional, Cuaron, J.J., additional, Zinovoy, M., additional, Hajj, C., additional, El Dika, I., additional, Pappou, E., additional, Tuli, R., additional, Connell, L., additional, Yaeger, R., additional, Smith, J.J., additional, Saltz, L., additional, Shia, J., additional, Weiser, M., additional, Garcia-Aguilar, J., additional, Wu, A.J., additional, Cercek, A., additional, Crane, C.H., additional, and Romesser, P.B., additional

Published
2020
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34. Predictors of Premature Ovarian Failure (POF) in Young Women with Locally Advanced Rectal Cancer (LARC) Treated with Pelvic Radiation Therapy (RT)

Author

Hilal, L., primary, Cercek, A., additional, Navilio, J., additional, Meier, H., additional, Zhang, Z., additional, Brady, P., additional, Wu, A.J., additional, Reyngold, M., additional, Cuaron, J.J., additional, Romesser, P.B., additional, Zinovoy, M., additional, Nusrat, M., additional, Pappou, E., additional, Guillem, J.G., additional, Garcia-Aguilar, J., additional, Paty, P., additional, Abu-Rustum, N., additional, Leitao, M.M., additional, Crane, C.H., additional, and Hajj, C., additional

Published
2020
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35. Neoadjuvant (Chemo)radiotherapy With Total Mesorectal Excision Only Is Not Sufficient to Prevent Lateral Local Recurrence in Enlarged Nodes: Results of the Multicenter Lateral Node Study of Patients With Low cT3/4 Rectal Cancer

Author

Ogura, A., Konishi, T., Cunningham, C., Garcia-Aguilar, J., Iversen, H., Toda, S., Lee, I.K., Lee, H.X., Uehara, K., Lee, P., Putter, H., Velde, C.J.H. van de, Beets, G.L., Rutten, H.J.T., Kusters, M., Aalbers, A.G.J., Aiba, T., Akiyoshi, T., Beets-Tan, R.G.H., Betts, M., Blazic, I.M., Brown, K.G., Campbell, N., Choi, M.H., Gollub, M.J., Hanaoka, Y., Kim, M.K., Meershoek-Klein-Kranenbarg, E., Kuroyanagi, H., Maas, M., Martling, A., Moore, J., Nieuwenhuijzen, G.A., Oh, S.N., Roodbeen, S., Sammour, T., Schaap, D., Solomon, M.J., Thomas, M., Tomizawa, K., Sande, M.E. van der, Suzuki, C., Valk, M.J.M. van der, Wells, T., Won, D.D., Lateral Node Study Consortium, Surgery, and RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy

Subjects
Cancer Research, medicine.medical_treatment, DISEASE, 03 medical and health sciences, 0302 clinical medicine, medicine, DISSECTION, Neoadjuvant therapy, RESECTION MARGIN, JAPAN, medicine.diagnostic_test, business.industry, Hazard ratio, Magnetic resonance imaging, Total mesorectal excision, Radiation therapy, Dissection, Oncology, 030220 oncology & carcinogenesis, METASTASIS, Resection margin, SURVIVAL, business, Nuclear medicine, PREOPERATIVE CHEMORADIOTHERAPY, Chemoradiotherapy, 030215 immunology, RADIOTHERAPY
Abstract

Purpose Improvements in magnetic resonance imaging (MRI), total mesorectal excision (TME) surgery, and the use of (chemo)radiotherapy ([C]RT) have improved local control of rectal cancer; however, we have been unable to eradicate local recurrence (LR). Even in the face of TME and negative resection margins (R0), a significant proportion of patients with enlarged lateral lymph nodes (LLNs) suffer from lateral LR (LLR). Japanese studies suggest that the addition of an LLN dissection (LLND) could reduce LLR. This multicenter pooled analysis aims to ascertain whether LLNs actually pose a problem and whether LLND results in fewer LLRs. Patients and Methods Data from 1,216 consecutive patients with cT3/T4 rectal cancers up to 8 cm from the anal verge who underwent surgery in a 5-year period were collected. LLND was performed in 142 patients (12%). MRIs were re-evaluated with a standardized protocol to assess LLN features. Results On pretreatment MRI, 703 patients (58%) had visible LLN, and 192 (16%) had a short axis of at least 7 mm. One hundred eight patients developed LR (5-year LR rate, 10.0%), of which 59 (54%) were LLRs (5-year LLR rate, 5.5%). After multivariable analyses, LLNs with a short axis of at least 7 mm resulted in a significantly higher risk of LLR (hazard ratio, 2.060; P = .045) compared with LLNs of less than 7 mm. In patients with LLNs at least 7 mm, (C)RT plus TME plus LLND resulted in a 5-year LLR of 5.7%, which was significantly lower than that in patients who underwent (C)RT plus TME (5-year LLR, 19.5%; P = .042). Conclusion LLR is still a significant problem after (C)RT plus TME in LLNs with a short axis at least 7 mm on pretreatment MRI. The addition of LLND results in a significantly lower LLR rate.

Published
2019

37. 93rd annual convention podium and poster abstracts

Author

Davis, C. M., Strong, S. A., Hellinger, M. D., Williamson, P. R., Larach, S. W., Ferrara, A., Blake, T. B., Medich, D. S., Ziv, Y., Oakley, J. R., Reissman, P., Piccirillo, M., Ulrich, A., Nogueras, J. J., Wexner, S. D., Rubin, M. S., Bodenstein, L. E., Kent, K. C., Williamson, M. E. R., Lewis, W. G., Sagar, P. M., Holdsworth, P. J., Johnston, D., Fazio, V. W., Goldblum, J. R., Sirimarco, M. T., Lavery, I. C., Petras, R. E., Treem, W. R., Cohen, J., Davis, P. M., Hyams, J. S., Eu, K. W., Bartolo, D. C. C., Green, J. D., Riether, R. D., Rosen, L., Stasik, J. J., Sheets, J. A., Reed, J., Khubchandani, I. T., Armitage, N. C., Chapman, M., Hardcastle, J. D., Viamonte, M., Plasencia, G., Wiltz, O., Jacobs, M., Finan, P. J., Passaro, M., Church, J. M., McGannon, E., Wilson, M., Hull-Boiner, S., Kollmorgen, C. F., Meagher, A. P., Wolff, B. G., Pemberton, J. H., Martenson, J. A., Ilstrup, D. M., Moran, M. R., Ramos, A., Rothenberger, D. A., Goldberg, S. M., Johnson, D., Madoff, R. D., Wong, W. D., Finne, III, C. O., Konishi, F., Furuta, K., Kanazawa, K., Lockhart, D., Schmitt, S., Caushaj, P. P., Garcia-Aguilar, J., Belmonte, C., Schiesel, E. C., Mazier, W. P., Senagore, A. J., Piccirillo, M. F., Teoh, T. -A., Yoon, K. -S., Paul, R. A. Patino, Lucas, J., Nelson, R., Norton, N., Cautley, E., Schouten, W. R., Briel, J. W., Auwerda, J. J. A., de Graaf, E. J. R., Lowry, A. C., Sentovich, S. M., Blatchford, G. J., Rivela, L. J., Thorson, A. G., Christensen, M. A., Jorge, J. M. N., Yang, Y. K., Shafik, A., Allendorf, J. D. F., Kayton, M. L., Libutti, S. K., Trokel, M. J., Whelan, R. L., Treat, M. R., Nowygrod, R., Bessler, M., Frank, R. E., Saclarides, T. J., Leurgans, S., Speziale, N. J., Drab, E., Rubin, D., Hull, T. L., Schroeder, T. K., Scholefield, J. H., Ogunbiyi, O. A., Smith, J. H. F., Rogers, K., Sharp, F., Longo, W. E., Vernava, III, A. M., Wade, T. P., Coplin, M. A., Virgo, K. S., Johnson, F. E., Brady, M., Kavolius, J., Quan, S. H. Q., Goldstein, E. T., Feldman, S., Shub, H. A., Bennett, D. R., Kumar, R., McMillen, M. A., Thornton, S., Khoury, D. A., Opelka, F. G., Teoh, T -A., Cohen, S. M., Weiss, E. G., Ortiz, H., De Miguel, M., Armendáriz, P., Rodriguez, J., Chocarro, C., Farouk, R., Dorrance, H. R., Duthie, G. S., Rainey, J. B., Morgado, Jr., P. J., Corman, M. L., Kawamura, Y. J., Sawada, T., Muto, T., Nagai, H., Hill, J., MacLennan, I., Binderow, S. R., Daniel, N., Ehrenpreis, E. D., Jensen, J. E., Bonner, G. F., Ruderman, W. B., Milsom, J. W., Gibbs, D. H., Beck, D. E., Hicks, T. C., Timmcke, A. E., Gathright, Jr, J. B., Cheong, D., Lucas, F. V., McGinity, M., Taylor, B. A., Godwin, P., Holdsworth, P., Lewis, W., Quirke, P., Williamson, M., Kokoszka, J., Pavel, D., Abcarian, H., Stephenson, B. M., Morgan, A. R., Salaman, J. R., Wheeler, M. H., Tran, T. C. K., Willemsen, W., Kuijpers, H. C., Lehman, J. F., Wiseman, J. S., MacFie, J., Sedman, P., May, J., Mancey-Jones, B., Johnstone, D., Nwariaku, F. E., Rochon, R. B., Huber, P. J., Carrico, C. J., Ortega, A., Beart, R., Winchester, D., Steele, G., Green, R., Caushaj, P. F., Devereaux, D., Griffey, S., Reiver, D., Kmiot, W. A., Baker, R., Luchtefeld, M. A., Anthone, G., Schlinkert, R., Roig, J. V., Villoslada, C., Solana, A., Alos, R., Hinojosa, J., Lledo, S., Johnson, D. R. E., Buie, W. D., Jensen, L. L., Heine, J., Hoffmann, B., Timmcke, A., Hicks, T., Opelka, F., Beck, D., Sousa, Jr., A., AraÚjo, S. A., Damico, F. M., Cordeiro, A. C., Pinotti, H. W., Gama, A. H., Fengler, S., Pearl, R., Orsay, C., Seow-Choen, F., Ho, J. M. S., Wiltz, O. H., Torregrosa, M., Brasch, R. C., Bufo, A. J., Krienberg, P., Johnson, G. P., Gowen, G. F., Mullen, P. D., Behrens, D., Hughes, T. G., Wynn, M., Pollack, J. S., Rajagopal, A. S., Huynh, T., Schanbacher, C., Hickson, W. G. E., Yang, Y. -K., Heymen, S., Choi, S. -K., Teoh, T. -A., Wexner, S. D., Vaccaro, C. A., Teoh, T. A., Nogueras, J. J., Choi, S. K., Cheong, D. M. O., Salanga, V. D., MacDonald, A., Baxter, J. N., Finlay, I. G., Mellgren, A., Bremmer, S., Dolk, A., Gillgren, P., Johansson, C., Ahlbäck, S. O., Udén, R., Holmström, B., Ferrara, A., O'Donovan, S., Larach, S. W., Williamson, P. R., Neto, J. A. Reis, Ciquini, S., Quilici, F. A., Reis, Jr., J. A., Torrabadella, L., Salgado, G., Whelan, R. L., Horvath, K. D., Golub, R., Ahsan, H., Cirocco, W., Ziv, Y., Fazio, V. W., Oakley, J. R., Church, J. M., Milsom, J. W., Lavery, L. C., Cohen, S. M., Kmiot, W. A., Reiver, D., Reissman, P., Weiss, E. G., Alós, R., García-Granero, E., Roig, J. V., Uribe, N., Sala, C., Lledo, S., Ozuner, G., Strong, S. A., Bufo, A. J., Daniels, G., Lieberman, R. C., Feldman, S., Lucas, F. V., Longo, W. E., Polites, G., Deshpande, Y., Vernava, A. M., Niehoff, M., Chandel, B., Berglund, D. D., Madoff, R. D., Gemlo, B. T., Spencer, M. P., Goldberg, S. M., Lowry, A. C., Marcello, P. W., Roberts, P. L., Schoetz, D. J., Murray, J. J., Coller, J. A., Veidenheimer, M. C., Koltun, W. A., Bloomer, M. M., Colony, P., Ruggeiro, F., Fleshner, P. R., Michelassi, F., Lewis, W., Williamson, M., Holdsworth, P., Finan, P., Ash, D., Johnston, D., Moran, M. R., Ramos, A., Rothenberger, D. A., Antonenko, D. R., Khanduja, K. S., Fitzgerald, S. D., Meagher, A. P., Moniz-Pereira, P., Wolff, B. G., Outwater, E. K., Marks, G. J., Mohiuddin, M., Sagar, P. M., Hartley, M. N., Mancey-Jones, B., Sedman, P., May, J., MacFie, J., Holbrook, R. F., Rodriguez-Bigas, M. A., Ramakrishnan, K., Palmer, M. L., Petrelli, N. J., Takahashi, T., Nivatvongs, S., Batts, K. P., Lucas, S. W., Klein, S. N., Keidan, R. D., Bannon, J. P., Zhou, J., Armitage, N. C., Hunt, L. M., Robinson, M. H., Hugkulstone, C. E., Clarke, B., Vernon, S. A., Gregson, R. H., Hardcastle, J. D., Ryan, M., Dutta, S., Levine, A., Ortega, A., Anthone, G., Beart, R., Dominguez, J. M., Saclarides, T. J., Bolan, P., Bines, S. D., Adachi, M., Watanabe, T., Sawada, T., Okinaga, K., Muto, T., Hase, K., Shatney, C., Mochizuki, H., Johnson, D., Ure, T., Dehghan, K., Andrus, C. A., Daniel, G. L., D'Emilia, J. C., Rodriguez-Bigas, M., Suh, O. K., Brewer, D. A., Fung, C., Chapuis, P., Bokey, E. L., Garcia, J. C., Banerjee, S., Remzi, F. H., Lavery, I. C., Jorge, J. M. N., Ger, G. C., Gonzalez, L., Gee, A. S., Roe, A. M., Durdey, P., Kaye, M. D., Kyzer, S., Gordon, P. H., Hasegawa, M., Bun, P. Tae, Ikeuchi, D., Onodera, H., Imamura, M., Maetani, S., Blake, T., Hellinger, M., Grewal, H., Klimstra, D. S., Cohen, A. M., Guillem, J. G., Rooney, P. S., Gifford, K. -A., Clarke, P. A., Kuhn, J. A., Bryce, K., Frank, N., Dignan, R. D., Lichliter, W. E., Franko, E., Jacobson, R. M., Preskitt, J. T., Lieberman, Z., Tulanon, P., Steinbach, H., McCarty, T., Simons, T., Plasencia, G., Viamonte, M., Wiltz, O., Jacobs, M., Chen, W. S., Leu, S. Y., Hsu, H., Bessler, M., Halverson, A., Kayton, M. L., Treat, M. R., Nowygrod, R., Congilosi, S., Madoff, R., Wong, W. D., Rothenberger, D., Buie, W. D., Paterson, R., Cartmill, J. A., Trokel, M. J., Gingold, B. S., Cooper, M., Gorfine, S. R., Bauer, J. J., Gelernt, I. M., Kreel, I., Harris, M. T., Vallejo, J. F., Kestenberg, A., Miyajima, N., Kano, N., Ishikawa, Y., Sakai, S., Yamakawa, T., Otchy, D. P., Van Heerden, J. A., Ilstrup, D. M., Weaver, A. L., Winter, L. D., Mav, J., Lee, P. Y., Vetto, J. T., Sullivan, E. S., Rabkin, J., Mayoral, J. L., Matas, A. J., Bove, P., Visser, T., Barkel, D., Villalba, M., Bendick, P., Glover, J., Golub, R. W., Cirocco, W. C., Daniel, N., Altringer, W., Domingues, J. M., Brubaker, L. T., Smith, C. S., Kumar, S., and Gilbert, P.

Published
1994
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39. Changes in the multidisciplinary management of rectal cancer from 2009 to 2015 and associated improvements in short‐term outcomes

Author

Roxburgh, C. S. D., primary, Strombom, P., additional, Lynn, P., additional, Cercek, A., additional, Gonen, M., additional, Smith, J. J., additional, Temple, L. K. F., additional, Nash, G. M., additional, Guillem, J. G., additional, Paty, P. B., additional, Shia, J., additional, Vakiani, E., additional, Yaeger, R., additional, Stadler, Z. K., additional, Segal, N. H., additional, Reidy, D., additional, Varghese, A., additional, Wu, A. J., additional, Crane, C. H., additional, Gollub, M. J., additional, Saltz, L. B., additional, Garcia‐Aguilar, J., additional, and Weiser, M. R., additional

Published
2019
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41. Rectal cancer lateral lymph nodes: multicentre study of the impact of obturator and internal iliac nodes on oncological outcomes.

Author

Schaap, D. P., Boogerd, L. S. F., Konishi, T., Cunningham, C., Ogura, A., Garcia-Aguilar, J., Beets, G. L., Suzuki, C., Toda, S., Lee, I. K., Sammour, T., Uehara, K., Lee, P., Tuynman, J. B., van de Velde, C. J. H., Rutten, H. J. T., and Kusters, M.

Subjects
LYMPH node cancer, RECTAL cancer, RECTUM, METASTASIS, LYMPH nodes
Abstract

Background: In patients with rectal cancer, enlarged lateral lymph nodes (LLNs) result in increased lateral local recurrence (LLR) and lower cancer-specific survival (CSS) rates, which can be improved with (chemo)radiotherapy ((C)RT) and LLN dissection (LLND). This study investigated whether different LLN locations affect oncological outcomes. Methods: Patients with low cT3-4 rectal cancer without synchronous distant metastases were included in this multicentre retrospective cohort study. All MRI was re-evaluated, with special attention to LLN involvement and response. Results: More advanced cT and cN category were associated with the occurrence of enlarged obturator nodes. Multivariable analyses showed that a node in the internal iliac compartment with a short-axis (SA) size of at least 7 mm on baseline MRI and over 4 mm after (C)RT was predictive of LLR, compared with a post-(C)RT SA of 4 mm or less (hazard ratio (HR) 5.74, 95 per cent c.i. 2.98 to 11.05 vs HR 1.40, 0.19 to 10.20; P<0.001). Obturator LLNs with a SA larger than 6 mm after (C)RT were associated with a higher 5-year distant metastasis rate and lowered CSS in patients who did not undergo LLND. The survival difference was not present after LLND. Multivariable analyses found that only cT category (HR 2.22, 1.07 to 4.64; P=0.033) and margin involvement (HR 2.95, 1.18 to 7.37; P=0.021) independently predicted the development of metastatic disease. Conclusion: Internal iliac LLN enlargement is associated with an increased LLR rate, whereas obturator nodes are associated with more advanced disease with increased distant metastasis and reduced CSS rates. LLND improves local control in persistent internal iliac nodes, and might have a role in controlling systemic spread in persistent obturator nodes. [ABSTRACT FROM AUTHOR]

Published
2021
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42. Mismatch repair deficient rectal cancer is resistant to induction combination chemotherapy

Author

Cercek, A., primary, Dos Santos Fernandes, G., additional, Roxburgh, C., additional, Ng, S., additional, Yaeger, R., additional, Segal, N., additional, Ganesh, K., additional, Reidy, D., additional, Smith, J.J., additional, Nash, G., additional, Guillem, J., additional, Paty, P., additional, Shia, J., additional, Garcia-Aguilar, J., additional, Diaz, L., additional, Crane, C., additional, Goodman, K., additional, Saltz, L., additional, Weiser, M., additional, and Stadler, Z., additional

Published
2018
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43. Comparing metastatic (M) young onset (YO) colorectal cancer (CRC) with average onset (AO): Do they differ clinically and genetically?

Author

Dos Santos Fernandes, G., primary, Chatila, W., additional, Yaeger, R., additional, Mendelsohn, R., additional, Stadler, Z., additional, Segal, N.H., additional, Varghese, A., additional, Reidy, D., additional, Diaz, L., additional, Shia, J., additional, Vakiani, E., additional, Hechtman, J., additional, Schultz, N., additional, Berger, M., additional, Hyman, D., additional, Solit, D., additional, Saltz, L., additional, Garcia Aguilar, J., additional, and Cercek, A., additional

Published
2018
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44. Effectiveness of a multidisciplinary patient care bundle for reducing surgical-site infections

Author

Weiser, M R, primary, Gonen, M, additional, Usiak, S, additional, Pottinger, T, additional, Samedy, P, additional, Patel, D, additional, Seo, S, additional, Smith, J J, additional, Guillem, J G, additional, Temple, L, additional, Nash, G M, additional, Paty, P B, additional, Baldwin-Medsker, A, additional, Cheavers, C E, additional, Eagan, J, additional, Garcia-Aguilar, J, additional, Afonso, A, additional, Aslam, A, additional, Burns, J, additional, Canny, M, additional, Cohen, N, additional, Evans, N, additional, Ferrari, C, additional, Fiordaliso, C, additional, Fitzpatrick, C, additional, Freeman, R, additional, Gilbert, M, additional, Hailemariam, M, additional, Hammel, J, additional, Healy, K, additional, Hoskins, W, additional, Isaac, L, additional, Kim, W, additional, Kitzler, R, additional, Levine, K, additional, Marcelli, A, additional, Marx, W, additional, Matthews, L, additional, Monether, C, additional, Nolan, S, additional, Ottey, H, additional, Patterson, P, additional, Prather, A, additional, Riffle, M, additional, Rodrigue, D, additional, Romanoff, S, additional, Russo, T, additional, Seo, S K, additional, Sepkowitz, K, additional, Sokoli, D, additional, Swift, L, additional, Vassallo, C, additional, Vincenzino, A, additional, Wall, L, additional, Walters, C, additional, Weiser, M R, additional, and Yeung, K, additional

Published
2018
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45. Multidisciplinary, perioperative care bundle decreases surgical site infection in patients undergoing synchronous colorectal/liver resection

Author

Tufts, L.S., primary, Jarnagin, E.D., additional, Flynn, J.R., additional, Gonen, M., additional, Guillem, J.G., additional, Paty, P.B., additional, Nash, G.M., additional, Smith, J.J., additional, Wei, I.H., additional, Dematteo, R.P., additional, D'Angelica, M.I., additional, Allen, P.J., additional, Kingham, T.P., additional, Balachandran, V.P., additional, Garcia-Aguilar, J., additional, Jarnagin, W.R., additional, and Weiser, M.R., additional

Published
2018
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46. Lymph node yield in right colectomy for cancer: a comparison of open, laparoscopic and robotic approaches.

Author

Widmar, M, Keskin, M, Strombom, P, Beltran, P, Chow, OS, Smith, JJ, Nash, GM, Shia, J, Russell, D, Garcia-Aguilar, J, Widmar, M, Keskin, M, Strombom, P, Beltran, P, Chow, OS, Smith, JJ, Nash, GM, Shia, J, Russell, D, and Garcia-Aguilar, J

Abstract

AIM: Studies have demonstrated a relationship between lymph node (LN) yield and survival after colectomy for cancer. The impact of surgical technique on LN yield has not been well explored. METHOD: This is a retrospective study of right colectomy (RC) for cancer at a single institution from 2012 to 2014. Exclusion criteria were previous colectomy and emergent and palliative operations. All data were collected by chart review. Primary outcomes were LN yield and the LN to length of surgical specimen (LN-LSS) ratio. Multivariable mixed models were created with surgeon and pathologist as random effects. Sensitivity analyses were performed to exclude Stage IV cancers and to analyse groups on an 'as-treated' basis. RESULTS: We identified 181 open (O-RC), 163 laparoscopic (L-RC) and 119 robotic (R-RC) right colectomies. O-RC was more commonly performed in women with metastatic disease. The mean LN yield was 28, 29 and 34 in O-RC, L-RC and R-RC, respectively; the respective mean LN-LSS ratios were 0.83, 0.91 and 1.0. The R-RC approach produced a higher LN yield than the other approaches (P < 0.01), and a higher LN-LSS ratio than O-RC (P < 0.01). These findings were unchanged in sensitivity analyses. CONCLUSION: Robotic right colectomy improves LN yield and the LN-LSS ratio, which may reflect better mesocolic excision. The effect of these findings on survival requires further investigation.

Published
2017

47. International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams

Author

Augestad KM, Lindsetmo RO, Stulberg J, Reynolds H, Senagore A, Champagne B, Heriot AG, Leblanc F, Delaney CP, Ambrosetti P, Andujar J, Baixuli J, Balen E, Baxter N, Beck D, Bemelman W, Bergamaschi R, Billingham R, Birch D, Bonardi R, Bonardi M, Bonjer J, Braga M, Buch H, Buechler M, Burnstein M, Campbell K, Caushaj P, Celebrezze J, Chang G, Cheong D, Cohen J, Colak T, Delaney C, Dhoore A, Douglas P, Dozois E, Efron J, Ellis N, Enker W, Fanelli RD, Fazio V, Fleshman J, Franklin M, Fry R, Garcia Aguilar J, Garcia Granero E, Habr Gama A, Hahnloser D, Harris G, Hasegawa H, Holm T, Horgan P, Hyman N, Irwin T, Joh YG, Jongen J, Kaiser A, Kang SB, Kariv Y, Kennedy R, Kessler H, Khan M, Kim SH, Krokowicz P, Kwok S, Lacy A, Larson D, Law WL, Lee E, Lippert H, Ludwig K, Lynch AC, MacRae H, Madbouly K, Maeda K, Marderstein E, Marino M, Marks J, Maurer C, McLeod R, Monson J, Mortensen N, Neary P, Newstead G, OBrien D, Orangio G, Orkin B, Page M, Påhlman L, Panis Y, Panton N, Pennickx F, Phang T, Pinedo Mancilla G, Post S, Rafferty J, Rajput A, Reis Neto dos JA, Rivadeneira D, Roselli J, Rosen H, Rossi G, Rouanet P, Rullier E, Schiedeck T, Schiessel R, Schlachta C, Schwenk W, Seow Choen F, Sim R, Sing WK, Stamos M, Sternberg J, Tuckson W, Vaccaro C, Vargas D, Vignali A, Vonen B, Weiss E, Wexner S, Whiteford M, Wibe A, Williams N, Woods R, Yamamoto T, Young Fadok T., UGOLINI, GIAMPAOLO, Augestad KM, Lindsetmo RO, Stulberg J, Reynolds H, Senagore A, Champagne B, Heriot AG, Leblanc F, Delaney CP, Ambrosetti P, Andujar J, Baixuli J, Balen E, Baxter N, Beck D, Bemelman W, Bergamaschi R, Billingham R, Birch D, Bonardi R, Bonardi M, Bonjer J, Braga M, Buch H, Buechler M, Burnstein M, Campbell K, Caushaj P, Celebrezze J, Chang G, Cheong D, Cohen J, Colak T, Delaney C, Dhoore A, Douglas P, Dozois E, Efron J, Ellis N, Enker W, Fanelli RD, Fazio V, Fleshman J, Franklin M, Fry R, Garcia-Aguilar J, Garcia-Granero E, Habr-Gama A, Hahnloser D, Harris G, Hasegawa H, Holm T, Horgan P, Hyman N, Irwin T, Joh YG, Jongen J, Kaiser A, Kang SB, Kariv Y, Kennedy R, Kessler H, Khan M, Kim SH, Krokowicz P, Kwok S, Lacy A, Larson D, Law WL, Lee E, Lippert H, Ludwig K, Lynch AC, MacRae H, Madbouly K, Maeda K, Marderstein E, Marino M, Marks J, Maurer C, McLeod R, Monson J, Mortensen N, Neary P, Newstead G, OBrien D, Orangio G, Orkin B, Page M, Påhlman L, Panis Y, Panton N, Pennickx F, Phang T, Pinedo Mancilla G, Post S, Rafferty J, Rajput A, Reis Neto dos JA, Rivadeneira D, Roselli J, Rosen H, Rossi G, Rouanet P, Rullier E, Schiedeck T, Schiessel R, Schlachta C, Schwenk W, Seow-Choen F, Sim R, Sing WK, Stamos M, Sternberg J, Tuckson W, Ugolini G, Vaccaro C, Vargas D, Vignali A, Vonen B, Weiss E, Wexner S, Whiteford M, Wibe A, Williams N, Woods R, Yamamoto T, Young-Fadok T., Augestad, K, Lindsetmo, R, Stulberg, J, Reynolds, H, Senagore, A, Champagne, B, Heriot, A, Leblanc, F, Delaney, C, Ambrosetti, P, Andujar, J, Baixuli, J, Balen, E, Baxter, N, Beck, D, Bemelman, W, Bergamaschi, R, Billingham, R, Birch, D, Bonardi, R, Bonardi, M, Bonjer, J, Braga, M, Buch, H, Buechler, M, Burnstein, M, Campbell, K, Caushaj, P, Celebrezze, J, Chang, G, Cheong, D, Cohen, J, Colak, T, Dhoore, A, Douglas, P, Dozois, E, Efron, J, Ellis, N, Enker, W, Fanelli, R, Fazio, V, Fleshman, J, Franklin, M, Fry, R, Garcia-Aguilar, J, Garcia-Granero, E, Habr-Gama, A, Hahnloser, D, Harris, G, Hasegawa, H, Holm, T, Horgan, P, Hyman, N, Irwin, T, Joh, Y, Jongen, J, Kaiser, A, Kang, S, Kariv, Y, Kennedy, R, Kessler, H, Khan, M, Kim, S, Krokowicz, P, Kwok, S, Lacy, A, Larson, D, Law, W, Lee, E, Lippert, H, Ludwig, K, Lynch, A, Macrae, H, Madbouly, K, Maeda, K, Marderstein, E, Marino, M, Marks, J, Maurer, C, Mcleod, R, Monson, J, Mortensen, N, Neary, P, Newstead, G, Obrien, D, Orangio, G, Orkin, B, Page, M, Pahlman, L, Panis, Y, Panton, N, Pennickx, F, Phang, T, Pinedo Mancilla, G, Post, S, Rafferty, J, Rajput, A, Reis Neto dos, J, Rivadeneira, D, Roselli, J, Rosen, H, Rossi, G, Rouanet, P, Rullier, E, Schiedeck, T, Schiessel, R, Schlachta, C, Schwenk, W, Seow-Choen, F, Sim, R, Sing, W, Stamos, M, Sternberg, J, Tuckson, W, Ugolini, G, Vaccaro, C, Vargas, D, Vignali, A, Vonen, B, Weiss, E, Wexner, S, Whiteford, M, Wibe, A, Williams, N, Woods, R, Yamamoto, T, and Young-Fadok, T

Subjects
medicine.medical_specialty, Internationality, Colorectal cancer, health care facilities, manpower, and services, medicine.medical_treatment, education, Preoperative care, Article, RECTAL CANCER, COLORECTAL SURGERY, Preoperative Care, MANAGEMENT, Medicine, Humans, Stage (cooking), health care economics and organizations, Neoadjuvant therapy, Neoplasm Staging, Patient Care Team, Rectal Neoplasm, medicine.diagnostic_test, business.industry, Rectal Neoplasms, General surgery, Cancer, Rectal examination, Vascular surgery, medicine.disease, humanities, Neoadjuvant Therapy, Surgery, Treatment Outcome, Health Care Survey, Health Care Surveys, Practice Guidelines as Topic, MULTIDISCIPLINARY TEAMS, Rectal Neoplasms - pathology - surgery - therapy, business, Human, Abdominal surgery
Abstract

Law, WL is one of the members of the International Rectal Cancer Study Group, BACKGROUND: Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates. METHODS: One hundred seventy-three international colorectal centers were invited to participate in a survey of preoperative management of rectal cancer. RESULTS: One hundred twenty-three (71%) responded, with a majority of respondents from North America, Europe, and Asia. Ninety-three percent have more than 5 years' experience with rectal cancer surgery. Fifty-five percent use CT scan, 35% MRI, 29% ERUS, 12% digital rectal examination and 1% PET scan in all RC cases. Seventy-four percent consider threatened circumferential margin (CRM) an indication for neoadjuvant treatment. Ninety-two percent prefer 5-FU-based long-course neoadjuvant chemoradiation therapy (CRT). A significant difference in practice exists between the US and non-US surgeons: poor histological differentiation as an indication for CRT (25% vs. 7.0%, p = 0.008), CRT for stage II and III rectal cancer (92% vs. 43%, p = 0.0001), MRI for all RC patients (20% vs. 42%, p = 0.03), and ERUS for all RC patients (43% vs. 21%, p = 0.01). Multidisciplinary team meetings significantly influence decisions for MRI (RR = 3.62), neoadjuvant treatment (threatened CRM, RR = 5.67, stage II + III RR = 2.98), quality of pathology report (RR = 4.85), and sphincter-saving surgery (RR = 3.81). CONCLUSIONS: There was little consensus on staging, neoadjuvant treatment, and preoperative management of rectal cancer. Regular multidisciplinary team meetings influence decisions about neoadjuvant treatment and staging methods., published_or_final_version

Published
2010

49. International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams

Author

Augestad, K, Lindsetmo, R, Stulberg, J, Reynolds, H, Senagore, A, Champagne, B, Heriot, A, Leblanc, F, Delaney, C, Ambrosetti, P, Andujar, J, Baixuli, J, Balen, E, Baxter, N, Beck, D, Bemelman, W, Bergamaschi, R, Billingham, R, Birch, D, Bonardi, R, Bonardi, M, Bonjer, J, Braga, M, Buch, H, Buechler, M, Burnstein, M, Campbell, K, Caushaj, P, Celebrezze, J, Chang, G, Cheong, D, Cohen, J, Colak, T, Dhoore, A, Douglas, P, Dozois, E, Efron, J, Ellis, N, Enker, W, Fanelli, R, Fazio, V, Fleshman, J, Franklin, M, Fry, R, Garcia-Aguilar, J, Garcia-Granero, E, Habr-Gama, A, Hahnloser, D, Harris, G, Hasegawa, H, Holm, T, Horgan, P, Hyman, N, Irwin, T, Joh, Y, Jongen, J, Kaiser, A, Kang, S, Kariv, Y, Kennedy, R, Kessler, H, Khan, M, Kim, S, Krokowicz, P, Kwok, S, Lacy, A, Larson, D, Law, W, Lee, E, Lippert, H, Ludwig, K, Lynch, A, Macrae, H, Madbouly, K, Maeda, K, Marderstein, E, Marino, M, Marks, J, Maurer, C, Mcleod, R, Monson, J, Mortensen, N, Neary, P, Newstead, G, Obrien, D, Orangio, G, Orkin, B, Page, M, Pahlman, L, Panis, Y, Panton, N, Pennickx, F, Phang, T, Pinedo Mancilla, G, Post, S, Rafferty, J, Rajput, A, Reis Neto dos, J, Rivadeneira, D, Roselli, J, Rosen, H, Rossi, G, Rouanet, P, Rullier, E, Schiedeck, T, Schiessel, R, Schlachta, C, Schwenk, W, Seow-Choen, F, Sim, R, Sing, W, Stamos, M, Sternberg, J, Tuckson, W, Ugolini, G, Vaccaro, C, Vargas, D, Vignali, A, Vonen, B, Weiss, E, Wexner, S, Whiteford, M, Wibe, A, Williams, N, Woods, R, Yamamoto, T, Young-Fadok, T, Augestad K. M., Lindsetmo R. -O., Stulberg J., Reynolds H., Senagore A., Champagne B., Heriot A. G., Leblanc F., Delaney C. P., Ambrosetti P., Andujar J., Baixuli J., Balen E., Baxter N., Beck D., Bemelman W., Bergamaschi R., Billingham R., Birch D., Bonardi R., Bonardi M., Bonjer J., Braga M., Buch H., Buechler M., Burnstein M., Campbell K., Caushaj P., Celebrezze J., Chang G., Cheong D., Cohen J., Colak T., Dhoore A., Douglas P., Dozois E., Efron J., Ellis N., Enker W., Fanelli R. D., Fazio V., Fleshman J., Franklin M., Fry R., Garcia-Aguilar J., Garcia-Granero E., Habr-Gama A., Hahnloser D., Harris G., Hasegawa H., Holm T., Horgan P., Hyman N., Irwin T., Joh Y. G., Jongen J., Kaiser A., Kang S. B., Kariv Y., Kennedy R., Kessler H., Khan M., Kim S. H., Krokowicz P., Kwok S., Lacy A., Larson D., Law W. L., Lee E., Lippert H., Ludwig K., Lynch A. C., MacRae H., Madbouly K., Maeda K., Marderstein E., Marino M., Marks J., Maurer C., McLeod R., Monson J., Mortensen N., Neary P., Newstead G., OBrien D., Orangio G., Orkin B., Page M., Pahlman L., Panis Y., Panton N., Pennickx F., Phang T., Pinedo Mancilla G., Post S., Rafferty J., Rajput A., Reis Neto dos J. A., Rivadeneira D., Roselli J., Rosen H., Rossi G., Rouanet P., Rullier E., Schiedeck T., Schiessel R., Schlachta C., Schwenk W., Seow-Choen F., Sim R., Sing W. K., Stamos M., Sternberg J., Tuckson W., Ugolini G., Vaccaro C., Vargas D., Vignali A., Vonen B., Weiss E., Wexner S., Whiteford M., Wibe A., Williams N., Woods R., Yamamoto T., Young-Fadok T., Augestad, K, Lindsetmo, R, Stulberg, J, Reynolds, H, Senagore, A, Champagne, B, Heriot, A, Leblanc, F, Delaney, C, Ambrosetti, P, Andujar, J, Baixuli, J, Balen, E, Baxter, N, Beck, D, Bemelman, W, Bergamaschi, R, Billingham, R, Birch, D, Bonardi, R, Bonardi, M, Bonjer, J, Braga, M, Buch, H, Buechler, M, Burnstein, M, Campbell, K, Caushaj, P, Celebrezze, J, Chang, G, Cheong, D, Cohen, J, Colak, T, Dhoore, A, Douglas, P, Dozois, E, Efron, J, Ellis, N, Enker, W, Fanelli, R, Fazio, V, Fleshman, J, Franklin, M, Fry, R, Garcia-Aguilar, J, Garcia-Granero, E, Habr-Gama, A, Hahnloser, D, Harris, G, Hasegawa, H, Holm, T, Horgan, P, Hyman, N, Irwin, T, Joh, Y, Jongen, J, Kaiser, A, Kang, S, Kariv, Y, Kennedy, R, Kessler, H, Khan, M, Kim, S, Krokowicz, P, Kwok, S, Lacy, A, Larson, D, Law, W, Lee, E, Lippert, H, Ludwig, K, Lynch, A, Macrae, H, Madbouly, K, Maeda, K, Marderstein, E, Marino, M, Marks, J, Maurer, C, Mcleod, R, Monson, J, Mortensen, N, Neary, P, Newstead, G, Obrien, D, Orangio, G, Orkin, B, Page, M, Pahlman, L, Panis, Y, Panton, N, Pennickx, F, Phang, T, Pinedo Mancilla, G, Post, S, Rafferty, J, Rajput, A, Reis Neto dos, J, Rivadeneira, D, Roselli, J, Rosen, H, Rossi, G, Rouanet, P, Rullier, E, Schiedeck, T, Schiessel, R, Schlachta, C, Schwenk, W, Seow-Choen, F, Sim, R, Sing, W, Stamos, M, Sternberg, J, Tuckson, W, Ugolini, G, Vaccaro, C, Vargas, D, Vignali, A, Vonen, B, Weiss, E, Wexner, S, Whiteford, M, Wibe, A, Williams, N, Woods, R, Yamamoto, T, Young-Fadok, T, Augestad K. M., Lindsetmo R. -O., Stulberg J., Reynolds H., Senagore A., Champagne B., Heriot A. G., Leblanc F., Delaney C. P., Ambrosetti P., Andujar J., Baixuli J., Balen E., Baxter N., Beck D., Bemelman W., Bergamaschi R., Billingham R., Birch D., Bonardi R., Bonardi M., Bonjer J., Braga M., Buch H., Buechler M., Burnstein M., Campbell K., Caushaj P., Celebrezze J., Chang G., Cheong D., Cohen J., Colak T., Dhoore A., Douglas P., Dozois E., Efron J., Ellis N., Enker W., Fanelli R. D., Fazio V., Fleshman J., Franklin M., Fry R., Garcia-Aguilar J., Garcia-Granero E., Habr-Gama A., Hahnloser D., Harris G., Hasegawa H., Holm T., Horgan P., Hyman N., Irwin T., Joh Y. G., Jongen J., Kaiser A., Kang S. B., Kariv Y., Kennedy R., Kessler H., Khan M., Kim S. H., Krokowicz P., Kwok S., Lacy A., Larson D., Law W. L., Lee E., Lippert H., Ludwig K., Lynch A. C., MacRae H., Madbouly K., Maeda K., Marderstein E., Marino M., Marks J., Maurer C., McLeod R., Monson J., Mortensen N., Neary P., Newstead G., OBrien D., Orangio G., Orkin B., Page M., Pahlman L., Panis Y., Panton N., Pennickx F., Phang T., Pinedo Mancilla G., Post S., Rafferty J., Rajput A., Reis Neto dos J. A., Rivadeneira D., Roselli J., Rosen H., Rossi G., Rouanet P., Rullier E., Schiedeck T., Schiessel R., Schlachta C., Schwenk W., Seow-Choen F., Sim R., Sing W. K., Stamos M., Sternberg J., Tuckson W., Ugolini G., Vaccaro C., Vargas D., Vignali A., Vonen B., Weiss E., Wexner S., Whiteford M., Wibe A., Williams N., Woods R., Yamamoto T., and Young-Fadok T.

Abstract

Background Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates. Methods One hundred seventy-three international colorectal centers were invited to participate in a survey of preoperative management of rectal cancer. Results One hundred twenty-three (71%) responded, with a majority of respondents from North America, Europe, and Asia. Ninety-three percent have more than 5 years' experience with rectal cancer surgery. Fifty-five percent use CT scan, 35% MRI, 29% ERUS, 12% digital rectal examination and 1% PET scan in all RC cases. Seventyfour percent consider threatened circumferential margin (CRM) an indication for neoadjuvant treatment. Ninety-two percent prefer 5-FU-based long-course neoadjuvant chemoradiation therapy (CRT). A significant difference in practice exists between the US and non-US surgeons: poor histological differentiation as an indication for CRT (25% vs. 7.0%, p = 0.008), CRT for stage II and III rectal cancer (92% vs. 43%, p = 0.0001), MRI for all RC patients (20% vs. 42%, p = 0.03), and ERUS for all RC patients (43% vs. 21%, p = 0.01). Multidisciplinary team meetings significantly influence decisions for MRI (RR = 3.62), neoadjuvant treatment (threatened CRM, RR = 5.67, stage II III RR = 2.98), quality of pathology report (RR = 4.85), and sphincter-saving surgery (RR = 3.81). Conclusions There was little consensus on staging, neoadjuvant treatment, and preoperative management of rectal cancer. Regular multidisciplinary team meetings influence decisions about neoadjuvant treatment and staging methods.

Published
2010

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