{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T22:33:56Z","timestamp":1790030036132,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T00:00:00Z","timestamp":1735776000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>In contrast to significant advances in organ preservation in locally advanced rectal cancer, the contemporary management of early\u2010stage rectal cancer, including the frequency of abdominoperineal resections, remains largely unexplored in the United States. Therefore, we assessed the utilization of neoadjuvant therapy and oncological resections in early\u2010stage rectal cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>This is a retrospective cohort study of patients with cT1\u2013T3N0 rectal cancer who underwent proctectomies between 2016 and 2022 in the National Surgical Quality Improvement Project proctectomy files. Multivariable logistic regression was used to identify factors associated with abdominoperineal resections and Kendall's tau statistics to evaluate clinical\u2010pathological staging agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In all, 3078 patients (29.6% cT1\u20132N0, 70.4% cT3N0) were included with 55.3% of tumours &lt;5\u2009cm from the anal verge. Overall, 58.2% received neoadjuvant therapy within 3\u2009months of surgery (30.6% for cT1\u2013T2N0 vs. 69.8% for cT3N0, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), and 58.6% underwent abdominoperineal resection (55.5% for cT1\u2013T2N0 vs. 59.9% for cT3N0, <jats:italic>P<\/jats:italic>\u2009=\u20090.058). The adjusted odds of undergoing abdominoperineal resection were associated with increasing age (OR 1.4 per every 10\u2010year increase; 95% CI 1.2\u20131.5), cT3N0 tumours (OR 1.7; 95% CI 1.1\u20132.7) and tumour location &lt;5\u2009cm from the anal verge (OR 10.6; 95% CI 7.7\u201314.7). There was a weak clinical\u2010pathological T staging correlation (Kendal tau coefficient 0.25; 95% CI 0.20\u20130.29).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this large cohort of patients with early\u2010stage rectal cancer with high rates of neoadjuvant therapy, over half of patients underwent abdominoperineal resection and one in five had a pathological complete response. These findings underscore opportunities for organ preservation in early\u2010stage rectal cancer, suggesting that treatments typically reserved for locally advanced disease may extend to early stages with the completion of ongoing clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.17281","type":"journal-article","created":{"date-parts":[[2025,1,2]],"date-time":"2025-01-02T22:51:03Z","timestamp":1735858263000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Contemporary practices in abdominoperineal resection for early\u2010stage rectal cancer in the United States"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8477-5924","authenticated-orcid":false,"given":"Totadri","family":"Dhimal","sequence":"first","affiliation":[{"name":"Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE) University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bailey K.","family":"Hilty Chu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE) University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0877-6500","authenticated-orcid":false,"given":"Anthony","family":"Loria","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE) University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Boyer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE) University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueya","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Computational Biology University of Rochester  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Health Policy and Outcomes Research, Department of Public Health Sciences University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Colugnati","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE) University of Rochester Medical Center  Rochester New York USA"},{"name":"School of Medicine Universidade Federal de Juiz de Fora  Juiz de Fora Minas Gerais Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Cupertino","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE) University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika E.","family":"Ramsdale","sequence":"additional","affiliation":[{"name":"James P. Wilmot Cancer Center University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fergal J.","family":"Fleming","sequence":"additional","affiliation":[{"name":"Department of Surgery, Surgical Health Outcomes and Research Enterprise (SHORE) University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2018.0037"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.4845"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(20)30333-2"},{"key":"e_1_2_12_5_1","unstructured":"Rectum: Stage Distribution of SEER Incidence Cases 2012\u20132021 [Internet]. National Cancer Institiue. Surveillance Epidemiology and End Results Program. [cited 5\/9\/2024]. 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