Photo Credit: semnic

The following is a summary of “Role of Combining Interim and Final Analysis by Using Endoscopic and Radiologic Methods in Total Neoadjuvant Treatment,” published in the November 2024 issue of Surgery by Erozkan et al. 

Individuals with rectal cancer underwent flexible sigmoidoscopy (FS), rectal magnetic resonance imaging (MRI), and their combinations to investigate complete response (CR) following total neoadjuvant treatment (TNT). 

Researchers conducted a retrospective study to compare the performance of FS and MRI in predicting the CR after TNT in rectal cancer. 

They evaluated the patients who opted for TNT from 2015–2022 and underwent restaging with FS and MRI. The concordance with CR was analyzed using the weighted-κ test. 

The results showed that 208 patients had a CR rate of 42.3%. Among individual methods, final flexible sigmoidoscopy (fFS) showed the highest sensitivity of 68.2% for detecting CR, with moderate concordance (κ=0.46). Additionally, only combinations of interim flexible sigmoidoscopy -final flexible sigmoidoscopy (iFS-fFS) and fFS-final MRI (fFS-fMRI) reached a concordance level like fFS alone. 

They concluded that the combination of fMRI and FS provided the highest concordance with CR and higher sensitivity, while interim MRI offered limited clinical value and may be omitted. 

Source: americanjournalofsurgery.com/article/S0002-9610(24)00656-1/abstract