ArticleAnnals of surgical oncology2023
MRI Assessment of Extramural Venous Invasion Before and After Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer and Its Association with Disease-Free and Overall Survival.
Article in Annals of surgical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- MRI Predicts Residual Disease and Outcomes in Watch-and-Wait Patients with Rectal Cancer.Radiology · 2024Trial
- MRI-defined parametrial venous invasion in locally advanced cervical cancer: association with pathological venous invasion, pretreatment lymph node metastasis, and survival outcomes.Japanese journal of radiology · 2026Article
- Four-Year Survival Outcomes of Personalized Total Neoadjuvant Therapy Versus Chemotherapy During the 'Wait Period' Versus Standard Chemoradiotherapy for Locally Advanced Rectal Cancer.Journal of gastrointestinal cancer · 2026Article
- EMVI as an independent predictor of recurrence and the role of chemotherapy in N0 colonic adenocarcinoma: retrospective Cox regression analysis (2015-2022).International journal of colorectal disease · 2026Article
- Article
- Clinical characteristics and survival outcomes of rectal cancer patients across different mrT3 substages determined by rectal MRI.International journal of colorectal disease · 2025Article
- Predictive value of rectal MRI variables for pathological complete response in locally advanced rectal cancer following neoadjuvant chemoradiotherapy.International journal of colorectal disease · 2025Article
- The role of superior hemorrhoidal vein ectasia in the preoperative staging of rectal cancer.Frontiers in oncology · 2024Article
- Investigating the Feasibility of Predicting KRAS Status, Tumor Staging, and Extramural Venous Invasion in Colorectal Cancer Using Inter-Platform Magnetic Resonance Imaging Radiomic Features.Diagnostics (Basel, Switzerland) · 2023Article
- Evaluating residual tumor after neoadjuvant chemotherapy for muscle-invasive urothelial bladder cancer: diagnostic performance and outcomes using biparametric vs. multiparametric MRI.Cancer imaging : the official publication of the International Cancer Imaging Society · 2023Article
- Extramural Venous Invasion and Tumor Deposit at Diffusion-weighted MRI in Patients after Neoadjuvant Treatment for Rectal Cancer.Radiology · 2023Article
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16 authors.
Funding
Abstract
backgroundExtramural venous invasion (EMVI) on baseline MRI is associated with poor prognosis in patients with locally advanced rectal cancer. This study investigated the association of persistent EMVI after total neoadjuvant therapy (TNT) (chemoradiotherapy and systemic chemotherapy) with survival.
methodsBaseline MRI, post-TNT MRI, and surgical pathology data from 175 patients with locally advanced rectal cancer who underwent TNT and total mesorectal excision between 2010 and 2017 were retrospectively analyzed for evidence of EMVI. Two radiologists assessed EMVI status with disagreement adjudicated by a third. Pathologic EMVI status was assessed per departmental standards. Cox regression models evaluated the associations between EMVI and disease-free and overall survival.
resultsEMVI regression on both post-TNT MRI and surgical pathology was associated with disease-free survival (hazard ratio, 0.17; 95% confidence interval (CI), 0.04-0.64) and overall survival (hazard ratio, 0.11; 95% CI, 0.02-0.68). In an exploratory analysis of 35 patients with EMVI on baseline MRI, only six had EMVI on pathology compared with 18 on post-TNT MRI; these findings were not associated (p = 0.2). Longer disease-free survival was seen with regression on both modalities compared with remaining positive. Regression on pathology alone, independent of MRI EMVI status, was associated with similar improvements in survival.
conclusionsBaseline EMVI is associated with poor prognosis even after TNT. EMVI regression on surgical pathology is common even with persistent EMVI on post-TNT MRI. EMVI regression on surgical pathology is associated with improved DFS, while the utility of post-TNT MRI EMVI persistence for decision-making and prognosis remains unclear.
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