Predicting Difficult Laparoscopic Total Mesorectal Excision for Locally-advanced Mid-low Rectal Cancer: The EuMaRCS Score Validation
Por:
de'ANGELIS N, Martínez-Pérez A, Vitali GC, Pigneur F, Luciani A, Brunetti F, Kraft M, Martí-Martínez E, Moroni P, Espin E, Ris F, Pucciarelli S and EuMaRCS Study Group
Publicada:
1 abr 2020
Resumen:
Background/Aim: The European MRI and Rectal Cancer Surgery (EuMaRCS) score was proposed to identify preoperatively difficult laparoscopic total mesorectal excision (L-TME) for locally advanced rectal cancer (LARC). This study aimed to test EuMaRCS's validity. Patients and Methods: Data were retrieved from a European multicenter database, including patients with mid/low LARC, treated with neoadjuvant chemoradiation therapy and L-TME with primary anastomosis. The EuMaRCS score was calculated on: BMI>30 (3 points), interspinous distance<96.4 mm (2 points), ymrT stage >= T3b (4 points), and male sex (1 point). Results: The sample was composed of 141 patients, of whom 23 (16.3%) had a difficult L-TME. The EuMaRCS score demonstrated high accuracy in predicting difficult surgery (AROC: 0.806, 95%CI=0.720.88), with a cut-off >3 being associated with the best balance in sensitivity (82.6%) and specificity (66.1%). Conclusion: The EuMaRCS score represents a validated tool to predict preoperatively difficult L-TME in LARC patients.
Filiaciones:
de'ANGELIS N:
Unit of Digestive, Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
:
Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain
Vitali GC:
Service of Abdominal Surgery, Geneva University Hospitals and Medical School, Geneva, Switzerland
Pigneur F:
Department of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
Luciani A:
Department of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
Kraft M:
Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Vall d'Hebron, Barcelona, Spain
:
Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain
Moroni P:
1 Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padua, Italy
Espin E:
Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Vall d'Hebron, Barcelona, Spain
Ris F:
Department of Radiology, Henri Mondor Hospital, AP-HP, University of Paris Est, UPEC, Créteil, France
Pucciarelli S:
1 Surgical Clinic, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padova, Padua, Italy
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