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Abstract：
In patients with locally advanced rectal cancer, restaging pelvis magnetic resonance imaging (MRI) after neoadjuvant concurrent chemoradiotherapy is recommended despite its limited accuracy in predicting pathologic T (ypT) and N (ypN) stage. Neoadjuvant rectal (NAR) score is a novel short-term surrogate endpoint for disease-free survival (DFS) and overall survival (OS). We tested the agreement between restaging MRI T (yT) and N (yN) with ypT and ypN stages, respectively, and explored the prognostic significance of restaging MRI NAR (mNAR) score.
Between 2014 and 2018, 43 patients with locally advanced rectal cancer completed neoadjuvant concurrent chemoradiotherapy, had a restaging MRI, and underwent surgery. Weighted kappa was used to test the agreement between yT and yN with ypT and ypN, respectively. A kappa value of less than 0.5 was deemed unacceptable. Paired t test was used to compare NAR and mNAR mean scores. Survival was estimated by Kaplan-Meier curves.
Restaging MRI could not predict ypT stage (slight agreement, κ = 0.111) or ypN stage (fair agreement, κ = 0.278). The mean mNAR score was higher than the mean NAR score (20 vs. 16, P = .0079). The median DFS for patients with low-intermediate NAR and high NAR was not reached vs. 30 months (P = .0063). The median OS for patients with low-intermediate NAR and high NAR was not reached vs. 40 months (P = .0056). There was a trend for longer DFS and OS in patients with low-intermediate mNAR scores (not reached in both groups, P = .058) compared to patients with high mNAR scores (not reached in both groups, P = .15).
Restaging MRI could not predict ypT and ypN stage. The mean mNAR score was higher than the mean NAR score. There was a trend for longer DFS and OS in patients with low-intermediate mNAR scores compared to patients with high mNAR scores.
Between 2014 and 2018, 43 patients with locally advanced rectal cancer completed neoadjuvant concurrent chemoradiotherapy, had a restaging MRI, and underwent surgery. Weighted kappa was used to test the agreement between yT and yN with ypT and ypN, respectively. A kappa value of less than 0.5 was deemed unacceptable. Paired t test was used to compare NAR and mNAR mean scores. Survival was estimated by Kaplan-Meier curves.
Restaging MRI could not predict ypT stage (slight agreement, κ = 0.111) or ypN stage (fair agreement, κ = 0.278). The mean mNAR score was higher than the mean NAR score (20 vs. 16, P = .0079). The median DFS for patients with low-intermediate NAR and high NAR was not reached vs. 30 months (P = .0063). The median OS for patients with low-intermediate NAR and high NAR was not reached vs. 40 months (P = .0056). There was a trend for longer DFS and OS in patients with low-intermediate mNAR scores (not reached in both groups, P = .058) compared to patients with high mNAR scores (not reached in both groups, P = .15).
Restaging MRI could not predict ypT and ypN stage. The mean mNAR score was higher than the mean NAR score. There was a trend for longer DFS and OS in patients with low-intermediate mNAR scores compared to patients with high mNAR scores.
摘要：
在局部晚期直肠癌患者中，尽管在预测病理T(ypT)和N(ypN)分期方面的准确性有限,但仍建议在新辅助同步放化疗后重建骨盆磁共振成像(MRI).新辅助直肠（NAR）评分是无病生存期（DFS）和总生存期（OS）的一种新的短期替代终点。我们测试了重新老化MRIT（yT）和N（yN）与ypT和ypN阶段之间的一致性，分别,并探讨MRINAR(mNAR)评分的预后意义。
2014年至2018年，43例局部晚期直肠癌患者完成了新辅助同步放化疗，重新做了核磁共振,接受了手术.用加权κ检验yT和yN与ypT和ypN的一致性，分别。小于0.5的kappa值被认为是不可接受的。采用配对t检验比较NAR和mNAR均分。通过Kaplan-Meier曲线估计存活率。
重新MRI无法预测ypT分期(轻微一致，κ=0.111)或ypN阶段(公平协议，κ=0.278）。平均mNAR评分高于平均NAR评分(20vs.16，P=.0079）。低-中NAR和高NAR患者的中位DFS未达到。30个月（P=0.0063）。低-中NAR和高NAR的患者的中位OS未达到与40个月（P=0.0056）。在mNAR评分较低至中等的患者中，有DFS和OS较长的趋势（两组均未达到，P=0.058）与高mNAR评分的患者相比（两组均未达到，P=.15）。
重新进行MRI无法预测ypT和ypN分期。平均mNAR评分高于平均NAR评分。与具有高mNAR评分的患者相比,具有低-中等mNAR评分的患者存在较长DFS和OS的趋势。
2014年至2018年，43例局部晚期直肠癌患者完成了新辅助同步放化疗，重新做了核磁共振,接受了手术.用加权κ检验yT和yN与ypT和ypN的一致性，分别。小于0.5的kappa值被认为是不可接受的。采用配对t检验比较NAR和mNAR均分。通过Kaplan-Meier曲线估计存活率。
重新MRI无法预测ypT分期(轻微一致，κ=0.111)或ypN阶段(公平协议，κ=0.278）。平均mNAR评分高于平均NAR评分(20vs.16，P=.0079）。低-中NAR和高NAR患者的中位DFS未达到。30个月（P=0.0063）。低-中NAR和高NAR的患者的中位OS未达到与40个月（P=0.0056）。在mNAR评分较低至中等的患者中，有DFS和OS较长的趋势（两组均未达到，P=0.058）与高mNAR评分的患者相比（两组均未达到，P=.15）。
重新进行MRI无法预测ypT和ypN分期。平均mNAR评分高于平均NAR评分。与具有高mNAR评分的患者相比,具有低-中等mNAR评分的患者存在较长DFS和OS的趋势。
