Economics of Preoperative Radiotherapy With Total Mesorectal Excision: What Can We Learn From the Dutch Experience?
Bibliographic record
Abstract
Patients undergoing rectal cancer surgery may also receive radiation therapy to reduce local tumor recurrence and improve survival [1,2]. In parts of Europe, a 5-day course of preoperative radiotherapy (PRT) alone is recommended for most patients, while other European and North American countries utilize a 5-week course of postoperative chemoradiotherapy for patients with stage II or III tumors [3]. Total mesorectal excision (TME) stresses sharp and complete dissection of the mesorectum, the lymph node– bearing portion of the rectum [4]. Compared with traditional blunt rectal cancer surgery, TME seems to lead to superior rates of sphincter preservation, local tumor control, and survival [4]. The Dutch Colorectal Cancer Group has conducted a randomized trial that compared outcomes of TME, with and without PRT, for patients with resectable rectal cancer [5]. At a median follow-up of 2 years, local recurrence rates were 2.4% and 8.2% for radiated and nonradiated patients, respectively, with no significant difference in overall survival [5]. These results may change with further follow-up. In this issue of the Journal of Clinical Oncology, van den
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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 | 0.002 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.007 | 0.005 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
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".