Prediction Models for Pathological Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer: A Systematic Review and Meta-Analysis

Background

Accurate pretreatment prediction of pCR is critical for stratifying patients with LARC and selecting candidates for organ-preserving approaches. However, pCR is a postoperative pathological endpoint, whereas watch-and-wait strategies are based on cCR. Despite a rapidly expanding literature encompassing gene expression signatures, MRI radiomics, deep learning, and multi-modal fusion models, no prior systematic review has comprehensively evaluated predictive performance across all modalities using contemporary meta-analytic techniques for diagnostic test accuracy.