{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T02:50:34Z","timestamp":1793242234837,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T00:00:00Z","timestamp":1662163200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T00:00:00Z","timestamp":1662163200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objectives<\/jats:title>\n                    <jats:p>Increasing evidence suggests patient\u2010oriented benefits of nonoperative management (NOM) for rectal cancer. However, vigilant surveillance requires excellent access to care. We sought to examine patient, socioeconomic, and facility\u2010level factors associated with NOM over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the National Cancer Database (2006\u20132017), we examined patients with Stage II\u2013III rectal adenocarcinoma, who received neoadjuvant chemoradiation and received NOM versus surgery. Factors associated with NOM were assessed using multivariable logistic regression with backward stepwise selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 59,196 surgical and 8520 NOM patients identified. NOM use increased from 12.9% to 15.9% between 2006 and 2017. Patients who were Black (adjusted odds ratio [aOR]: 1.36, 95% confidence interval [CI]: 1.26\u20131.47), treated at community cancer centers (aOR: 1.22, 95% CI: 1.12\u20131.30), without insurance (aOR: 1.87, 95% CI: 1.68\u20132.09), and with less education (aOR: 1.53, 95% CI: 1.42\u20131.65) exhibited higher odds of NOM. Patients treated at high\u2010volume centers (aOR: 0.79, 95% CI: 0.74\u20130.84) and those who traveled &gt;25.6 miles for care (aOR: 0.59, 95% CI: 0.55\u20130.64) had lower odds of NOM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vulnerable groups who traditionally have difficulty accessing comprehensive cancer care were more likely to receive NOM, suggesting that healthcare disparities may be driving utilization. More research is needed to understand NOM decision\u2010making in rectal cancer treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.27082","type":"journal-article","created":{"date-parts":[[2022,9,3]],"date-time":"2022-09-03T10:18:21Z","timestamp":1662200301000},"page":"1504-1511","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Current trends in nonoperative management for rectal adenocarcinoma: An unequal playing field?"],"prefix":"10.1002","volume":"126","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0571-5000","authenticated-orcid":false,"given":"Katherine C.","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-3783","authenticated-orcid":false,"given":"Beiqun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurt","family":"Pianka","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanglei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Eisenstein","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Ramamoorthy","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole E.","family":"Lopez","sequence":"additional","affiliation":[{"name":"Department of Surgery University of California, San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,3]]},"reference":[{"issue":"2","key":"e_1_2_9_2_1","first-page":"89","article-title":"Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors","volume":"14","author":"Rawla P","year":"2019","journal-title":"Prz Gastroenterol"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i33.4850"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001762"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000080823.38569.b0"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000758"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.1054"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30074-2"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000141194.27992.32"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2018.5896"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(10)70172-8"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djaa003"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(15)00467-2"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31078-X"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000754"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000001707"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.2066"},{"key":"e_1_2_9_18_1","unstructured":"American College of Surgeons.2021.About Cancer Program Categories. 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