In locally advanced low rectal cancer with anal canal invasion, should elective inguinal irradiation be performed?
Bibliographic record
Abstract
Abstract Objective: The aim of this study was to investigate whether omitting elective inguinal irradiation during neoadjuvant or adjuvant (chemo)radiotherapy is feasible for patients with locally advanced low rectal cancer (LALRC) with anal canal invasion (ACI). Study design: A total of 90 LALRC patients with ACI who underwent neoadjuvant or adjuvant (chemo)radiotherapy between 2011 and 2021 were recruited. Inguinal lymph node (ILN) was clinically negative on presentation. Failure pattern, ILN recurrence rate, survival data and prognostic factors were analysed. Results: The 3-year ILN failure rate was 4.94%. 1 patient developed isolated ILN failure, which was successfully salvaged by surgery. The 3-year locoregional disease free survival (LRFS), distant metastatic recurrence free survival (DMRFS), and overall survival (OS) were 81.1%, 77.0%, and 86.8% respectively. In multivariate cox regression analysis, positive pathological lymph node after neoadjuvant treatment predicted worse LRFS (odd ratio [OR] 10.57, P= 0.00001), DMRFS (OR 9.17, P= 0.0002), and OS (OR 12.92, P= 0.0005). Positive tumour resection margin correlated with worse LRFS (OR 23.53, P= 0.001), DMRFS (OR 12.62, P= 0.002) and OS (OR 47.24, P= 0.002). Concurrent chemotherapy to RT was associated with better LRFS (OR 28.32, P= 0.002). ≥ Grade 3 acute and chronic toxicities occurred in 44.4% and 11.1% respectively in patients with elective inguinal radiation compared with 19.8% and 11.1% respectively in patients who did not receive it. Conclusion: Omission of elective inguinal irradiation was associated with a low inguinal failure rate for LALRC with ACI. It can spare patients from unnecessary acute radiotherapy toxicities.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.005 |
| 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 teacher head, 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".