E-ISSN: 1305-3612
Predictive value of MRI-detected extramural vascular invasion in stage T3 rectal cancer patients before neoadjuvant chemoradiation
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Abdominal Imaging - Original Article
VOLUME: 24 ISSUE: 3
P: 128-134
May 2018

Predictive value of MRI-detected extramural vascular invasion in stage T3 rectal cancer patients before neoadjuvant chemoradiation

Diagn Interv Radiol 2018;24(3):128-134
DOI: 10.5152/dir.2018.17286
Yiqun Sun 1
Jianwen Li 2
Lijun Shen 3
Xiaolin Wang 4
Tong Tong 5
Yajia Gu 6
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
6. Department of Radiology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
No information available.
No information available
Received Date: 23.08.2017
Accepted Date: 17.02.2018
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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.