{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T05:48:09Z","timestamp":1764049689679,"version":"3.45.0"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"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":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Individual components of surgical quality in locally advanced rectal cancer (LARC) \u2013 circumferential and distal resection margins and mesorectal completeness \u2013 are known prognostic factors. However, their combined prognostic value as a composite score remains underexplored. This study aimed to evaluate the impact of a composite quality total mesorectal excision (TME) score on oncological outcomes, and how this effect may vary with intervals from neoadjuvant therapy (NAT) to surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective, multicentre cohort study included patients with LARC treated between 2005 and 2020 across six referral centres in the CRONOS study. Patients were categorised by the composite quality TME (successful\/unsuccessful) and by the NAT\u2010to\u2010TME interval: short (\u22648\u2009weeks), intermediate (&gt;8 to \u226412), or long (&gt;12). Primary outcomes were locoregional recurrence (LR), systemic recurrence (SR), and overall survival (OS) in the unsuccessful group. The interaction between the composite score and NAT\u2010to\u2010TME interval was assessed as a secondary outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 1485 patients, 191 (12.9%) had an unsuccessful composite quality TME. This was significantly associated with increased risk of LR (HR 4.63, 95% CI: 3.04\u20137.05), SR (HR 2.10, 95% CI: 1.56\u20132.81), and reduced OS (HR 2.31, 95% CI: 1.79\u20132.98). Short and intermediate intervals increased the risk of LR in the unsuccessful group (\n                      <jats:italic>p<\/jats:italic>\n                      <jats:sub>interaction<\/jats:sub>\n                      \u2009=\u20090.06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patients with an unsuccessful composite quality TME are at high risk of recurrence and death. The link between shorter NAT\u2010to\u2010surgery intervals and poorer outcomes in this subgroup suggests that extending the interval beyond 12\u2009weeks may help optimise results in selected patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70291","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:49:13Z","timestamp":1761709753000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of the composite quality resection score for rectal cancer on oncological outcomes in a multicentre cohort study (\n                    <scp>CRONOS<\/scp>\n                    )"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4124-8590","authenticated-orcid":false,"given":"Yoelimar","family":"Guzm\u00e1n","sequence":"first","affiliation":[{"name":"Section of Colon and Rectal Surgery Unit, General and Digestive Surgery Department, Institute of Digestive and Metabolic Diseases, Hospital Clinic of Barcelona Universitat de Barcelona  Barcelona Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jes\u00fas","family":"Paredes","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, General and Digestive Surgery Department Hospital Cl\u00ednico Universitario de Santiago  Santiago de Compostela Galicia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Gonz\u00e1lez\u2010Atienza","sequence":"additional","affiliation":[{"name":"Section of Colon and Rectal Surgery Unit, General and Digestive Surgery Department, Institute of Digestive and Metabolic Diseases, Hospital Clinic of Barcelona Universitat de Barcelona  Barcelona Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joan","family":"Maurel","sequence":"additional","affiliation":[{"name":"Medical Oncology Departments, Hospital Clinic of Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumors Group \u2010 IDIBAPS Universitat de Barcelona  Barcelona Catalonia Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Hep\u00e1ticas y Digestivas (CIBEREHD)  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Fern\u00e1ndez\u2010L\u00f3pez","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, General and Digestive Surgery Department Hospital Cl\u00ednico Universitario de Santiago  Santiago de Compostela Galicia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Borja","family":"Prada","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, General and Digestive Surgery Department Hospital Cl\u00ednico Universitario de Santiago  Santiago de Compostela Galicia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Pascual","sequence":"additional","affiliation":[{"name":"Section of Colon and Rectal Surgery Unit, General Surgery Department Hospital del Mar  Barcelona Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda A.","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Section of Colon and Rectal Surgery Unit, General Surgery Department Hospital del Mar  Barcelona Catalonia Spain"},{"name":"General and Digestive Surgery Department Hospital Universitario Joan XXIII  Tarragona Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c1lvaro","family":"Garc\u00eda\u2010Granero","sequence":"additional","affiliation":[{"name":"Coloproctology Unit, Health Research Institute of the Balearic Islands (IdISBa), 3D\u2010Reconstruction Unit and Simulation Centre, Hospital Universitario Son Espases, Professor of Human Embriology and Anatomy Department University of Islas Baleares  Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Coloproctology Unit Hospital Universitario Son Espases  Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aina","family":"Ochogavia\u2010Segu\u00ed","sequence":"additional","affiliation":[{"name":"Coloproctology Unit Hospital Universitario Son Espases  Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarita","family":"Gamundi\u2010Cuesta","sequence":"additional","affiliation":[{"name":"Coloproctology Unit Hospital Universitario Son Espases  Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesc X.","family":"Gonz\u00e1lez\u2010Argente","sequence":"additional","affiliation":[{"name":"Coloproctology Unit Hospital Universitario Son Espases  Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3356-8378","authenticated-orcid":false,"given":"Ana","family":"Centeno","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, General and Digestive Surgery Department Consorci Sanitari Integral \u2010 Hospital General de l'Hospitalet  Barcelona Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Sobrerroca\u2010Porras","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, General and Digestive Surgery Department Consorci Sanitari Integral \u2010 Hospital General de l'Hospitalet  Barcelona Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordi","family":"Castellvi\u2010Valls","sequence":"additional","affiliation":[{"name":"Colorectal Surgery Unit, General and Digestive Surgery Department Consorci Sanitari Integral \u2010 Hospital General de l'Hospitalet  Barcelona Catalonia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Gil\u2010G\u00f3mez","sequence":"additional","affiliation":[{"name":"General and Digestive Surgery Department Hospital Cl\u00ednico Universitario Virgen de la Arrixaca  Murcia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"G\u00f3mez\u2010P\u00e9rez","sequence":"additional","affiliation":[{"name":"General and Digestive Surgery Department Hospital Cl\u00ednico Universitario Virgen de la Arrixaca  Murcia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"Gil\u2010Mart\u00ednez","sequence":"additional","affiliation":[{"name":"General and Digestive Surgery Department Hospital Cl\u00ednico Universitario Virgen de la Arrixaca  Murcia Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio M.","family":"Lacy","sequence":"additional","affiliation":[{"name":"Section of Colon and Rectal Surgery Unit, General and Digestive Surgery Department, Institute of Digestive and Metabolic Diseases, Hospital Clinic of Barcelona Universitat de Barcelona  Barcelona Catalonia Spain"},{"name":"Chief of Instituto Quir\u00fargico Lacy  Barcelona Catalonia Spain"},{"name":"Hospital Ruber Internacional  Madrid Spain"},{"name":"Clinica Rotger  Palma de Mallorca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9","family":"R\u00edos","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Hospital Clinic and Medical Statistics Core Facility Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)  Barcelona Spain"},{"name":"Biostatistics Unit, Faculty of Medicine Universitat Aut\u00f2noma de Barcelona  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. 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