ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2022
The prognostic value of extramural venous invasion in preoperative MRI of rectal cancer patients.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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5 citing papers in PubMed, 8 citations in OpenAlex.
- Locally Recurrent Rectal Cancer in the Lateral Compartment: Imaging Features and Association with Primary Tumour Characteristics.Annals of surgical oncology · 2026Article
- Neoadjuvant Radiochemotherapy and Total Neoadjuvant Therapy in the Management of Locally Advanced Rectal Cancer.Cureus · 2025Article
- Survival outcomes of different neoadjuvant treatment regimens in patients with locally advanced rectal cancer and MRI-detected extramural venous invasion.Cancer medicine · 2023Article
- The prognostic value of extramural venous invasion in preoperative MRI of rectal cancer patients.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2022Article
- Extramural vascular invasion nomogram before radical resection of rectal cancer based on magnetic resonance imaging.Frontiers in oncology · 2022Article
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4 authors at 1 institution in 1 country.
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Abstract
aimThis study aimed to examine the prognostic value of extramural venous invasion observed in preoperative MRI on survival and recurrences.
methodIn total, 778 rectal cancer patients were evaluated in multidisciplinary meetings in Helsinki University Hospital during the years 2016-2018. 635 patients met the inclusion criteria of stage I-III disease and were intended for curative treatment at the time of diagnosis. 128 had extramural venous invasion in preoperative MRI.
resultsThe median follow-up time was 2.5 years. In a univariate analysis extramural venous invasion was associated with poorer disease-specific survival (hazard ratio [HR] 2.174, 95% CI 1.118-4.224, P = 0.022), whereas circumferential margin ≤1 mm, tumour stage ≥T3c or nodal positivity were not. Disease recurrence occurred in 17.3% of the patients: 13.4% had metastatic recurrence only, 1.7% mere local recurrence and 2.2% both metastatic and local recurrence. In multivariate analysis, extramural venous invasion (HR 1.734, 95% CI 1.127-2.667, P = 0.012) and nodal positivity (HR 1.627, 95% CI 1.071-2.472, P = 0.023) were risk factors for poorer disease-free survival (DFS). Circumferential margin ≤1 mm was a risk factor for local recurrence in multivariate analysis (HR 5.675, 95% CI 1.274-25.286, P = 0.023).
conclusionIn MRI, circumferential margin ≤1 mm is a risk factor for local recurrence, but the risk is quite well controlled with chemoradiotherapy and extended surgery. Extramural venous invasion instead is a significant risk factor for poorer DFS and new tools to reduce the systemic recurrence risk are needed.
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