E-ISSN 1305-3612
Abdominal Imaging - Original Article
Predictive value of MRI-detected extramural vascular invasion in stage T3 rectal cancer patients before neoadjuvant chemoradiation
1 Shanghai Institute of Medical Imaging, Fudan University; Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China  
2 Department of Urology, Shanxi Academy of Medical Science, Shanxi Dayi Hospital, Shanxi, China  
3 Department of Radiation Oncology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China  
4 Shanghai Institute of Medical Imaging, Fudan University, Shanghai, China  
5 Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China  
Diagn Interv Radiol 2018; 24: 128-134
DOI: 10.5152/dir.2018.17286
Abstract

 

PURPOSE: We set out to explore the probability of MRI-detected extramural vascular invasion (mr-EMVI) before chemoradiation to predict responses to chemoradiation and survival in stage T3 rectal cancer patients. 

 

METHODS: A total of 100 patients with T3 rectal cancer who underwent MRI examination and received neoadjuvant chemoradiation and surgery were enrolled. The correlation between mr-EMVI and other clinical factors were analyzed by chi-square. Logistic regression model was performed to select the potential factors influencing tumor responses to neoadjuvant chemoradiation. A Cox proportional hazards regression model was performed to explore potential predictors of survival.

 

RESULTS: The positive mr-EMVI result was more likely to be present in patients with a higher T3 subgroup (T3a+b = 7.1% vs. T3c+d = 90.1%, P < 0.001) and more likely in patients with mesorectal fascia involvement than in those without MRF (65% vs. 38.8%, P = 0.034). Compared with mr-EMVI (+) patients, more mr-EMVI (-) patients showed a good response (staged ≤ ypT2N0) (odds ratio [OR], 3.020; 95% confidence interval [CI], 1.071–8.517; P = 0.037). In univariate analysis, mr-EMVI (+) (hazard ratio [HR], 5.374; 95% CI, 1.210–23.872; P = 0.027) and lower rectal cancers (HR, 3.326; 95% CI, 1.135–9.743; P = 0.028) were significantly associated with decreased disease-free survival. A positive mr-EMVI status (HR, 5.727; 95% CI, 1.286–25.594; P = 0.022) and lower rectal cancers (HR, 3.137; 95% CI, 1.127–8.729; P = 0.029) also served as prognostic factors related to decreased disease-free survival in multivariate analysis.

 

CONCLUSION: The mr-EMVI status before chemoradiation is a significant prognostic factor and could be used for identifying T3 rectal cancer patients who might benefit from neoadjuvant chemoradiation.

 

You may cite this article as: Sun Y, Li J, Shen L, Wang X, Tong T, Gu Y.  Predictive value of MRI-detected extramural vascular invasion in stage T3 rectal cancer patients before neoadjuvant chemoradiation. Diagn Interv Radiol 2018; 24:128-134.

 

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