Local recurrence after rectal cancer treatment in Manitoba.
Bibliographic record
Abstract
BACKGROUND: By optimizing surgical and/or radiotherapy treatment, local recurrence rates of resectable rectal cancers have been reported to be less than 10% in both clinical trials and in some population-based studies. We examined patterns of care and local recurrence rates for rectal cancers in the province of Manitoba. METHODS: We used the provincial cancer registry to identify all rectal cancers diagnosed from 1994 to 1997. These dates allowed for a minimum of 5 years of follow-up. We obtained information on cancer staging through a retrospective chart review and information on surgical procedures from the cancer registry. We included in our study only those patients with stages I, II and III disease who had an anterior resection, Hartmann procedure or abdominal perineal resection with clear margins. We determined local recurrences by chart review and we reported the crude rate. RESULTS: We identified 333 patients among whom there was a relatively even distribution of stage I, II and III cancers. Fifty-three percent of patients received a stoma. Adjuvant radiotherapy was administered in 6%, 45% and 80% of patients with stage I, II and III cancers, respectively. Radiotherapy was only given preoperatively to 3 patients. We identified local recurrences in 13%, 16% and 24% of patients with stage I, II and III disease, respectively, with an overall rate of 17.4%. Recurrence rates by hospital ranged from 12% to 43%. Actual rates may be a few percentage points higher because 13% of patients had incomplete follow-up information and were assumed to have no recurrence. CONCLUSION: Between 1994 and 1997, the management of resectable rectal cancer in Manitoba did not meet benchmarks for the period in terms of documentation, treatment and, most importantly, the outcome of local recurrence. Initiatives should be taken to ensure that current performance and outcomes have improved.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".