{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T16:33:28Z","timestamp":1764002008132,"version":"3.37.3"},"reference-count":15,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T00:00:00Z","timestamp":1429574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Belgian Ministry of Health"},{"DOI":"10.13039\/501100011068","name":"Fondation Saint-Luc","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011068","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100013845","name":"Foundation against cancer","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100013845","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Institute for Disease and Invalidity Insurance (INAMI\/RIZIV)"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>A three\u2010grade system for macroscopic evaluation of the resection plane is used to describe the quality of total mesorectal excision (<jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content>). In several studies, two of the three grades have been combined when analysing the outcome. The aim of our study was to compare the predictive value of the three\u2010graded with that of a two\u2010graded <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The quality of <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content> in 1382 patients who underwent elective resection for mid or low rectal adenocarcinoma was registered by 65 hospitals in <jats:styled-content style=\"fixed-case\">PROCARE<\/jats:styled-content>, a Belgian multidisciplinary improvement project. Prediction of outcome based on the classic three\u2010grade score was compared with a two\u2010grade scoring system in which intramesorectal resection (<jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content>) was combined with mesorectal (<jats:styled-content style=\"fixed-case\">MRR<\/jats:styled-content>) or with muscularis propria resection (<jats:styled-content style=\"fixed-case\">MPR<\/jats:styled-content>). End\u2010points included the local recurrence rate, distant metastasis rate (<jats:styled-content style=\"fixed-case\">DMR<\/jats:styled-content>), disease\u2010free survival (<jats:styled-content style=\"fixed-case\">DFS<\/jats:styled-content>) and overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the 1382 resections, 63% were <jats:styled-content style=\"fixed-case\">MRR<\/jats:styled-content>, 27% <jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content> and 9% <jats:styled-content style=\"fixed-case\">MPR<\/jats:styled-content>. No significant differences were found in local recurrence between the different grades of <jats:styled-content style=\"fixed-case\">TME<\/jats:styled-content>. A two\u2010grade score distinguishing <jats:styled-content style=\"fixed-case\">MRR<\/jats:styled-content> from the others was found to predict <jats:styled-content style=\"fixed-case\">DMR<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> DFS<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> as well as the three\u2010grade score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The discriminatory and predictive value of a two\u2010grade score, differentiating <jats:styled-content style=\"fixed-case\">MRR<\/jats:styled-content> from the combined <jats:styled-content style=\"fixed-case\">IMR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MPR<\/jats:styled-content>, was as good as the classic three\u2010grade score.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12931","type":"journal-article","created":{"date-parts":[[2015,2,25]],"date-time":"2015-02-25T14:16:54Z","timestamp":1424873814000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Scoring the quality of total mesorectal excision for the prediction of cancer\u2010specific outcome"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9787-2133","authenticated-orcid":false,"given":"D.","family":"Leonard","sequence":"first","affiliation":[{"name":"Colorectal Surgery Unit Cliniques universitaires Saint\u2010Luc Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Penninckx","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery University Clinic Gasthuisberg Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Laenen","sequence":"additional","affiliation":[{"name":"I\u2010Biostat Katholieke Universiteit Leuven and Universiteit Hasselt Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Kartheuser","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit Cliniques universitaires Saint\u2010Luc Brussels Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"PROCARE","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,4,21]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010580"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60484-0"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60485-2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.07.010"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11888-012-0124-7"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24387"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.02153.x"},{"volume-title":"Quality Assurance for Rectal Cancer Phase 1: Good Clinical Practice for the Treatment of Rectal Cancer","author":"Penninckx F","key":"e_1_2_8_9_1"},{"volume-title":"Indicators for the Management of Upper Gastrointestinal Cancer. 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