Intestine and Lower Gastrointestinal Tract · 27 April 2026

Pelvic MRI is unreliable post-neoadjuvant therapy for rectal cancer.

40% of patients with a complete clinical response (CCR) endoscopically had residual disease on MRI.
After a mean follow-up of 4.8 years, 30% had disease regrowth, with no significant difference in rates based on MRI results (33% vs. 27.8%).

Surgeons should be cautious in relying solely on MRI for treatment decisions following total neoadjuvant therapy, as endoscopic CCR does not guarantee a lack of disease.

67% of patients with positive MRI findings did not experience regrowth after 4 years.

Journal Article by Suss NR, Johnson R (…) Shogan BD et 4 al. in J Surg Oncol

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