{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T01:22:34Z","timestamp":1751160154897,"version":"3.40.5"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,23]],"date-time":"2023-07-23T00:00:00Z","timestamp":1690070400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Neoadjuvant rectal (NAR) score is an early surrogate for longer\u2010term outcomes in rectal cancer undergoing radiotherapy and resection. In an era of increasing organ preservation, resection specimens are not always available to calculate the NAR score. Post\u2010treatment magnetic resonance imaging (MRI) re\u2010staging of regression is subjective, limiting reproducibility. We explored the potential for a novel MRI\u2010based NAR score (mrNAR) adapted from the NAR formula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Locally advanced rectal cancer patients undergoing neoadjuvant therapy (nCRT) and surgery were retrospectively identified between 2008 and 2020 in a single cancer network. mrNAR was calculated by adapting the NAR formula, replacing pathological (p) stages with post\u2010nCRT MR stages (<jats:italic>ymr<\/jats:italic>). Cox regression assessed relationships between clinicopathological characteristics, NAR and mrNAR with overall survival (OS) and recurrence\u2010free survival (RFS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 381 NAR and 177 mrNAR scores were calculated. On univariate analysis NAR related to OS (hazard ratio [HR] 2.05, 95% confidence interval [CI] 1.33\u20133.14, <jats:italic>p<\/jats:italic>\u2009=\u20090.001) and RFS (HR 2.52, 95% CI 1.77\u20133.59, <jats:italic>p<\/jats:italic>\u2009=\u20090.001). NAR 3\u2010year OS &lt;8 was 95.3%, 8\u201316 was 88.6% and &gt;16 was 80%. mrNAR related to OS (HR 2.96, 95% CI 1.38\u20136.34, <jats:italic>p<\/jats:italic>\u2009=\u20090.005) and RFS (HR 2.99, 95% CI 1.49\u20136.00, <jats:italic>p<\/jats:italic>\u2009=\u20090.002). 3\u2010year OS for mrNAR &lt;8 was 96.2%, 8\u201316 was 92.4% and &gt;16 was 78%. On multivariate analysis, mrNAR was a stage\u2010independent predictor of OS and RFS. mrNAR corresponded to NAR score category in only 15% (positive predictive value 0.23) and 47.5% (positive predictive value 0.48) of cases for categories &lt;8 and &gt;16, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neoadjuvant rectal score is validated as a surrogate end\u2010point for long\u2010term outcomes. mrNAR categories do not correlate with NAR but have stage\u2010independent prognostic value. mrNAR may represent a novel surrogate end\u2010point for future neoadjuvant treatments that focus on organ preservation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.16667","type":"journal-article","created":{"date-parts":[[2023,7,24]],"date-time":"2023-07-24T03:54:52Z","timestamp":1690170892000},"page":"1783-1794","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The neoadjuvant rectal score and a novel magnetic resonance imaging based neoadjuvant rectal score are stage independent predictors of long\u2010term outcome in locally advanced rectal cancer"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0827-5351","authenticated-orcid":false,"given":"Ross K.","family":"McMahon","sequence":"first","affiliation":[{"name":"Academic Unit of Surgery, School of Cancer Sciences, College of Medical, Veterinary and Life Sciences University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sean M.","family":"O'Cathail","sequence":"additional","affiliation":[{"name":"Wolfson Wohl Cancer Research Centre, School of Cancer Sciences, College of Medical, Veterinary and Life Sciences University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harikrishnan","family":"Nair","sequence":"additional","affiliation":[{"name":"Academic Unit of Surgery, School of Cancer Sciences, College of Medical, Veterinary and Life Sciences University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin W.","family":"Steele","sequence":"additional","affiliation":[{"name":"Academic Unit of Surgery, School of Cancer Sciences, College of Medical, Veterinary and Life Sciences University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Platt","sequence":"additional","affiliation":[{"name":"Radiology\/Imaging Department Glasgow Royal Infirmary  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Digby","sequence":"additional","affiliation":[{"name":"Radiology\/Imaging Department Glasgow Royal Infirmary  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alec C.","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Clinical Oncology, Beatson West of Scotland Cancer Centre  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul G.","family":"Horgan","sequence":"additional","affiliation":[{"name":"Academic Unit of Surgery, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences University of Glasgow  Glasgow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Campbell S. 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