Endoscopic Feature and Response Reproducibility in Tumor Assessment after Neoadjuvant Therapy for Rectal Adenocarcinoma.
Endoscopic Feature and Response Reproducibility in Tumor Assessment after Neoadjuvant Therapy for Rectal Adenocarcinoma.
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DOI：
10.1245/s10434-021-09827-w
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发表时间：
2021-09
影响因子：
3.7
通讯作者：
Garcia-Aguilar J
中科院分区：
文献类型：
--
作者：
Felder SI;Patil S;Kennedy E;Garcia-Aguilar J
在新辅助治疗后获得完全临床反应的选定直肠癌患者中，观察和等待可能是安全的。在确定肿瘤反应的完整性时，内窥镜检查是至关重要的，然而，还没有系统的研究。两个横断面调查，每个包含直肠癌新辅助治疗的内窥镜照片，分发给外科医生。第一项调查使用41张独特的内窥镜照片评估了8项内窥镜标准的重复性。计算外科医生为每张照片选择每种预先指定的内窥镜标准的百分比，以确定在评估多名外科医生的治疗/肿瘤反应等级时内窥镜标准的重复性。第二项调查包括17名患者新辅助治疗前后的内窥镜照片。外科医生分配肿瘤反应等级(完全临床反应、接近完全、不完全)，并计算正确诊断分配的百分比。在用于肿瘤反应分级的预定义内窥镜特征的选择上，外科医生间和外科内存在显著差异，而在肿瘤反应分级(CCR、NCR或ICR)的选择上，外科医生间和外科内医生之间也存在显著差异。然而，个体内窥镜特征和肿瘤反应分级聚集在一起，表明对肿瘤反应的解释是一致的。外科医生识别完全反应的患者(82%)比不完全反应的患者(68%)更准确。尽管外科医生之间和外科医生内部存在差异，但对于肿瘤的反应等级，内窥镜特征被选得很好，聚集在一起，表明内窥镜解释的一致性。外科医生倾向于低估肿瘤反应的程度，更准确地识别完整的反应而不是不完整的反应。
Watch and Wait may be safe in selected rectal cancer patients achieving a complete clinical response following neoadjuvant treatment. Endoscopic examination is critical when determining completeness of tumor response, however, has not been systematically studied Two cross-sectional surveys, each containing endoscopic photos of rectal cancers treated with neoadjuvant therapy, were distributed to surgeons. The first survey assessed reproducibility of eight endoscopic criteria using 41 unique endoscopic photos. The percentage of surgeons selecting each of the pre-specified endoscopic criteria for each photo was calculated to determine reproducibility of endoscopic criteria in assessing treatment/tumor response grade across multiple surgeons. The second survey included endoscopic pairs of pre- and post-neoadjuvant treatment photos of 17 patients. Surgeons assigned a tumor response grade (complete clinical response, near complete, incomplete), and percentages of correct diagnostic assignment were calculated. There was significant inter- and intra-surgeon variation in the selection of pre-defined endoscopic features used to grade tumor response as well as significant inter- and intra-surgeon variation in the selection of the tumor response grade (cCR, nCR, or iCR). However, individual endoscopic features and tumor response grade clustered together, suggesting consistency in tumor response interpretation. Surgeons were more accurate in identifying patients with a complete response (82%) than patients with an incomplete response (68%). Despite inter- and intra-surgeon variation, endoscopic features were well-selected for tumor response grade, clustering together and suggesting consistency in endoscopic interpretation. Surgeons tended to under-estimate the degree of tumor response, identifying complete rather than incomplete responses more accurately.
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影响因子：
168.9
作者：
van der Valk, Maxime J. M.;Hilling, Denise E.;van de Velde, Cornelis J. H.
通讯作者：
van de Velde, Cornelis J. H.
影响因子：
3.7
作者：
Maas M;Lambregts DM;Nelemans PJ;Heijnen LA;Martens MH;Leijtens JW;Sosef M;Hulsewé KW;Hoff C;Breukink SO;Stassen L;Beets-Tan RG;Beets GL
通讯作者：
Beets GL
影响因子：
3.9
作者：
García-Aguilar, J;de Anda, EH;Rothenberger, DA
通讯作者：
Rothenberger, DA
DOI：
10.1016/s1470-2045(15)00004-2
发表时间：
2015-08
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Garcia-Aguilar J;Chow OS;Smith DD;Marcet JE;Cataldo PA;Varma MG;Kumar AS;Oommen S;Coutsoftides T;Hunt SR;Stamos MJ;Ternent CA;Herzig DO;Fichera A;Polite BN;Dietz DW;Patil S;Avila K;Timing of Rectal Cancer Response to Chemoradiation Consortium
通讯作者：
Timing of Rectal Cancer Response to Chemoradiation Consortium
影响因子：
3.9
作者：
Battersby, Nick J.;Juul, Therese;Moran, Brendan J.
通讯作者：
Moran, Brendan J.