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A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis

Overview of attention for article published in The Lancet Gastroenterology & Hepatology, July 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (97th percentile)
  • High Attention Score compared to outputs of the same age and source (98th percentile)

Mentioned by

news
5 news outlets
policy
1 policy source
twitter
104 tweeters

Citations

dimensions_citation
172 Dimensions

Readers on

mendeley
188 Mendeley
Title
A watch-and-wait approach for locally advanced rectal cancer after a clinical complete response following neoadjuvant chemoradiation: a systematic review and meta-analysis
Published in
The Lancet Gastroenterology & Hepatology, July 2017
DOI 10.1016/s2468-1253(17)30074-2
Pubmed ID
Authors

Fahima Dossa, Tyler R Chesney, Sergio A Acuna, Nancy N Baxter

Abstract

A watch-and-wait approach for patients with clinical complete response to neoadjuvant chemoradiation could avoid the morbidity of conventional surgery for rectal cancer. However, the safety of this approach is unclear. We synthesised the evidence for watch-and-wait as a treatment for rectal cancer. We systematically searched MEDLINE, Embase, and the grey literature (up to June 28, 2016) for studies of patients with rectal adenocarcinoma managed by watch-and-wait after complete clinical response to neoadjuvant chemoradiation. We determined the proportion of 2-year local regrowth after watch-and-wait. We assessed non-regrowth recurrence, cancer-specific mortality, disease-free survival, and overall survival from studies comparing patients who had watch-and-wait versus those who had radical surgery after detection of clinical complete response or versus patients with pathological complete response. We identified 23 studies including 867 patients with median follow-up of 12-68 months. Pooled 2-year local regrowth was 15·7% (95% CI 11·8-20·1); 95·4% (95% CI 89·6-99·3) of patients with regrowth had salvage therapies. There was no significant difference between patients managed with watch-and-wait after a clinical complete response and patients with pathological complete response identified at resection with respect to non-regrowth recurrence (risk ratio [RR] 1·46, 95% CI 0·70-3·05) or cancer-specific mortality (RR 0·87, 95% CI 0·38-1·99). Although there was no significant difference in overall survival between groups (hazard ratio [HR] 0·73, 95% CI 0·35-1·51), disease-free survival was better in the surgery group (HR 0·47, 95% CI 0·28-0·78). We found no significant difference between patients managed with watch-and-wait and patients with clinical complete response treated with surgery in terms of non-regrowth recurrence (RR 0·58, 95% CI 0·18-1·90), cancer-specific mortality (RR 0·58, 95% CI 0·06-5·84), disease-free survival (HR 0·56, 95% CI 0·20-1·60), or overall survival (HR 3·91, 95% CI 0·57-26·72). Most patients treated by watch-and-wait avoid radical surgery and of those who have regrowth almost all have salvage therapy. Although we detected no significant differences in non-regrowth cancer recurrence or overall survival in patients treated with watch-and-wait versus surgery, few patients have been studied and more prospective studies are needed to confirm long-term safety. None.

Twitter Demographics

The data shown below were collected from the profiles of 104 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 188 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 1 <1%
Unknown 187 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 40 21%
Student > Ph. D. Student 23 12%
Other 17 9%
Student > Doctoral Student 17 9%
Student > Master 16 9%
Other 47 25%
Unknown 28 15%
Readers by discipline Count As %
Medicine and Dentistry 108 57%
Engineering 5 3%
Biochemistry, Genetics and Molecular Biology 4 2%
Nursing and Health Professions 4 2%
Agricultural and Biological Sciences 3 2%
Other 12 6%
Unknown 52 28%

Attention Score in Context

This research output has an Altmetric Attention Score of 99. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 January 2020.
All research outputs
#233,378
of 16,649,395 outputs
Outputs from The Lancet Gastroenterology & Hepatology
#62
of 888 outputs
Outputs of similar age
#7,429
of 269,962 outputs
Outputs of similar age from The Lancet Gastroenterology & Hepatology
#2
of 53 outputs
Altmetric has tracked 16,649,395 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 888 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 32.7. This one has done particularly well, scoring higher than 93% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 269,962 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 97% of its contemporaries.
We're also able to compare this research output to 53 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 98% of its contemporaries.