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A multi-centred randomised trial of radical surgery versus adjuvant chemoradiotherapy after local excision for early rectal cancer

Overview of attention for article published in BMC Cancer, July 2016
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1 tweeter


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93 Mendeley
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A multi-centred randomised trial of radical surgery versus adjuvant chemoradiotherapy after local excision for early rectal cancer
Published in
BMC Cancer, July 2016
DOI 10.1186/s12885-016-2557-x
Pubmed ID

W. A. A. Borstlap, P. J. Tanis, T. W. A. Koedam, C. A. M. Marijnen, C. Cunningham, E. Dekker, M. E. van Leerdam, G. Meijer, N. van Grieken, I. D. Nagtegaal, C. J. A. Punt, M. G. W. Dijkgraaf, J. H. De Wilt, G. Beets, E. J. de Graaf, A. A. W van Geloven, M. F. Gerhards, H. L. van Westreenen, A. W. H. van de Ven, P. van Duijvendijk, I. H. J. T. de Hingh, J. W. A. Leijtens, C. Sietses, E. J. Spillenaar-Bilgen, R. J. C. L. M. Vuylsteke, C. Hoff, J. W. A. Burger, W. M. U. van Grevenstein, A. Pronk, R. J. I. Bosker, H. Prins, A. B. Smits, S. Bruin, D. D. Zimmerman, L. P. S. Stassen, M. S. Dunker, M. Westerterp, P. P. Coene, J. Stoot, W. A. Bemelman, J. B. Tuynman


Rectal cancer surgery is accompanied with high morbidity and poor long term functional outcome. Screening programs have shown a shift towards more early staged cancers. Patients with early rectal cancer can potentially benefit significantly from rectal preserving therapy. For the earliest stage cancers, local excision is sufficient when the risk of lymph node disease and subsequent recurrence is below 5 %. However, the majority of early cancers are associated with an intermediate risk of lymph node involvement (5-20 %) suggesting that local excision alone is not sufficient, while completion radical surgery, which is currently standard of care, could be a substantial overtreatment for this group of patients. In this multicentre randomised trial, patients with an intermediate risk T1-2 rectal cancer, that has been locally excised using an endoluminal technique, will be randomized between adjuvant chemo-radiotherapylimited to the mesorectum and standard completion total mesorectal excision (TME). To strictly monitor the risk of locoregional recurrence in the experimental arm and enable early salvage surgery, there will be additional follow up with frequent MRI and endoscopy. The primary outcome of the study is three-year local recurrence rate. Secondary outcomes are morbidity, disease free and overall survival, stoma rate, functional outcomes, health related quality of life and costs. The design is a non inferiority study with a total sample size of 302 patients. The results of the TESAR trial will potentially demonstrate that adjuvant chemoradiotherapy is an oncological safe treatment option in patients who are confronted with the difficult clinical dilemma of a radically removed intermediate risk early rectal cancer by polypectomy or transanal surgery that is conventionally treated with subsequent radical surgery. Preserving the rectum using adjuvant radiotherapy is expected to significantly improve morbidity, function and quality of life if compared to completion TME surgery. NCT02371304 , registration date: February 2015.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter 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 93 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 93 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 18 19%
Other 10 11%
Student > Bachelor 9 10%
Student > Master 6 6%
Student > Postgraduate 5 5%
Other 17 18%
Unknown 28 30%
Readers by discipline Count As %
Medicine and Dentistry 47 51%
Nursing and Health Professions 6 6%
Pharmacology, Toxicology and Pharmaceutical Science 2 2%
Agricultural and Biological Sciences 2 2%
Computer Science 1 1%
Other 4 4%
Unknown 31 33%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 July 2016.
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Outputs from BMC Cancer
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Outputs of similar age
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Outputs of similar age from BMC Cancer
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Altmetric has tracked 13,560,184 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,098 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 18th percentile – i.e., 18% of its peers scored the same or lower than it.
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 263,017 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 16th percentile – i.e., 16% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one.