{
  "abstract": "Background: Neoadjuvant radiotherapy (RT) has been the standard of care for locally advanced rectal cancer (LARC) for over two decades. Adjuvant RT use in LARC represents a deviation from standard care and warrants further investigation.\n\nObjectives: To identify factors associated with adjuvant RT utilization. We hypothesized that sociodemographic determinants contribute to differences in the sequence of radiation treatment among patients with rectal cancer.\n\nMethods: This retrospective cohort study utilized the National Cancer Database (2015–2022) to identify adults with clinical stage II–III rectal adenocarcinoma undergoing surgery and RT. Patients were categorized by RT sequence (neoadjuvant vs. adjuvant). Multivariable logistic regression identified factors associated with use of adjuvant RT.\n\nResults: Of the included 48 452 patients, 6.9% received adjuvant RT. Compared with the neoadjuvant group, adjuvant RT recipients exhibited higher rates of pathologic upstaging (20.5% vs. 10.3%), positive margins (14.7% vs. 6.3%), and lymphovascular invasion (17.4% vs. 11.3%; all p < 0.001). On multivariable analysis, positive margins (aOR 1.78, 95% CI 1.43–2.22), lymphovascular invasion (aOR 1.96, 95% CI 1.66–2.31), upstaging (aOR 1.63, 1.31–2.02) were independently associated with adjuvant RT.\n\nConclusions: Adjuvant RT appeared to be used in patients who were found to have high‐risk tumor pathology postoperatively.",
  "abstract_shown": true,
  "affiliations": [
    "Section of Surgical Sciences, Vanderbilt University Medical Center Nashville Tennessee USA",
    "University of Texas Health Science Center at San Antoni San Antonio Texas USA",
    "Department of Surgery Division of Colon & Rectal Surgery, Harbor‐UCLA Medical Center Torrance California USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Maryam Sherwani",
      "orcid": "0000-0002-0925-1848"
    },
    {
      "affs": [
        1
      ],
      "name": "Danish Ali"
    },
    {
      "affs": [
        2
      ],
      "name": "Hanjoo Lee",
      "orcid": "0000-0002-0373-0784"
    },
    {
      "affs": [
        0
      ],
      "name": "Alexander T. Hawkins"
    },
    {
      "affs": [
        0
      ],
      "name": "Aimal Khan",
      "orcid": "0000-0003-2851-8330"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3w18cqgtxc548.bib",
  "cited_by": 0,
  "doi": "10.1002/jso.70365",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13732548/",
  "id": "3w18cqgtxc548",
  "issns": [
    "0022-4790",
    "1096-9098"
  ],
  "landing_url": "https://doi.org/10.1002/jso.70365",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Colorectal"
    ],
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2730|Colorectal Cancer Surgical Treatments"
    ]
  ],
  "openalex": "W7210277753",
  "pdf_url": "https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/jso.70365",
  "pmcid": "PMC13732548",
  "pmid": "42702067",
  "published": "2026-09-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3w18cqgtxc548.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:30Z",
      "native_id": "PMC13732548",
      "source": "pmc",
      "url": "https://doi.org/10.1002/jso.70365"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Colorectal Cancer Surgical Treatments",
      "subfield": "oncology"
    }
  ],
  "title": "Factors Associated With Receipt of Adjuvant Radiation in Locally Advanced Rectal Cancer",
  "title_text": "Factors Associated With Receipt of Adjuvant Radiation in Locally Advanced Rectal Cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:30Z",
  "url": "https://research.draconitic.com/paper/3w18cqgtxc548",
  "venue": "Journal of Surgical Oncology",
  "versions": []
}