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Hodges, Nicola; Battersby, Nicholas; Rao, Sheela; Brown, Gina; Anandappa, Gayathri; Cunningham, David; Tait, Diana; Tekkis, Paris; Chong, Irene; Aitken, Katharine; Chau, Ian; Rasheed, Shahnawaz; Balyasnikova, Svetlana; Moran, Brendan; Falk, Stephen; Sizer, Bruce; Branagan, Graham; O’Toole, Lorcan; Adusumalli, Madhavi; Nagtegaal, Iris; Von Loga, Katharina; Thrower, Andrew; Jackson, Andrew; Roach, Huw; [...]

Relationship Between Baseline Rectal Tumor Length and Magnetic Resonance Tumor Regression Grade Response to Chemoradiotherapy: A Subanalysis of the TRIGGER Feasibility Study

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  • Media type: E-Article
  • Title: Relationship Between Baseline Rectal Tumor Length and Magnetic Resonance Tumor Regression Grade Response to Chemoradiotherapy: A Subanalysis of the TRIGGER Feasibility Study
  • Contributor: Hodges, Nicola; Battersby, Nicholas; Rao, Sheela; Brown, Gina; Anandappa, Gayathri; Cunningham, David; Tait, Diana; Tekkis, Paris; Chong, Irene; Aitken, Katharine; Chau, Ian; Rasheed, Shahnawaz; Balyasnikova, Svetlana; Moran, Brendan; Falk, Stephen; Sizer, Bruce; Branagan, Graham; O’Toole, Lorcan; Adusumalli, Madhavi; Nagtegaal, Iris; Von Loga, Katharina; Thrower, Andrew; Jackson, Andrew; Roach, Huw; [...]
  • Published: Springer Science and Business Media LLC, 2023
  • Published in: Annals of Surgical Oncology, 30 (2023) 8, Seite 4729-4735
  • Language: English
  • DOI: 10.1245/s10434-022-11914-5
  • ISSN: 1068-9265; 1534-4681
  • Origination:
  • Footnote:
  • Description: Abstract Background It is widely believed that small rectal tumors are more likely to have a good response to neoadjuvant treatment, which may influence the selection of patients for a ‘watch and wait’ strategy. Objective The aim of this study was to investigate whether there is a relationship between baseline tumor length on magnetic resonance imaging (MRI) and response to chemoradiotherapy. Method The 96 patients with locally advanced rectal cancer randomised (2:1–intervention:control) in the TRIGGER feasibility study where eligible. Baseline tumor length was defined as the maximal cranio-caudal length on baseline MRI (mm) and was recorded prospectively at study registration. Magnetic resonance tumor regression grade (mrTRG) assessment was performed on the post-chemoradiotherapy (CRT) MRI 4–6 weeks (no later than 10 weeks) post completion of CRT. This was routinely reported for patients in the intervention (mrTRG-directed management) arm and reported for the purposes of this study by the central radiologist in the control arm patients. Those with an mrTRG I/II response were defined as ‘good responders’ and those with an mrTRG III–V response were defined as ‘poor responders’. Results Overall, 94 patients had a post-CRT MRI performed and were included. Forty-three (46%) patients had a good response (mrTRG I/II) and 51 (54%) patients had a poor response (mrTRG III/IV). The median tumor length of good responders was 43 mm versus 50 mm (p < 0.001), with considerable overlap in tumor lengths between groups. Conclusion Baseline tumor length on MRI is not a clinically useful biomarker to predict mrTRG tumor response to CRT and therefore patient suitability for a deferral of surgery trial.