ArticleCancer medicine2023
Survival outcomes of different neoadjuvant treatment regimens in patients with locally advanced rectal cancer and MRI-detected extramural venous invasion.
Article in Cancer medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Neoadjuvant chemotherapy versus long-course neoadjuvant chemoradiotherapy for locally advanced rectal cancer: a systematic review and meta-analysis of 5,168 cases.Frontiers in oncology · 2025Pooled it
- Synthetic Phase-Sensitive Inversion Recovery and Extramural Vascular Invasion Scoring Systems for Vascular Invasion Detection and Metastasis Risk in Rectal Cancer.Radiology. Imaging cancer · 2026Article
- Total Neoadjuvant Therapy Versus Long-Course Chemoradiotherapy in Locally Advanced Rectal Cancer: Real-World Tumor Response and Clinical Outcomes.Medical sciences (Basel, Switzerland) · 2026Article
- Predictors of Pathologic Non-response to Neoadjuvant Approaches in Locally Advanced Rectal Cancer.Annals of surgical oncology · 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
- Efficacies of radiotherapy in rectal cancer patients treated with total mesorectal excision or other types of surgery: an updated meta-analysis.Oncology reviews · 2025Review
- Article
- The role of superior hemorrhoidal vein ectasia in the preoperative staging of rectal cancer.Frontiers in oncology · 2024Article
- Survival outcomes of different neoadjuvant treatment regimens in patients with locally advanced rectal cancer and MRI-detected extramural venous invasion.Cancer medicine · 2023Article
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7 authors at 2 institutions in 1 country.
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Abstract
purposeMRI-detected extramural venous invasion (mrEMVI) is associated with poor survival outcomes in patients with locally advanced rectal cancer (LARC). An mrEMVI-positive status is considered a strong indication for neoadjuvant treatment, but the optimal regimen is unknown. PATIENTS AND
methodsWe retrospectively compared pathological and survival outcomes of 584 patients diagnosed with mrEMVI-positive rectal cancer between January 2013 and October 2021, and receiving either neoadjuvant chemotherapy (NCT) alone, neoadjuvant chemoradiotherapy (nCRT) alone, or nCRT plus NCT, prior to total mesorectal excision. Propensity score matching (PSM) was used to balance clinical bias between groups, which were compared using chi-square testing and Kaplan-Meier curves.
resultsMedian follow-up was 33.9 (range, 10.2-100.4) months. The 3-year overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and locoregional relapse-free survival (LRFS) rates for all patients were 90.4%, 57.5%, 61.1%, and 85.7%, respectively. Of 584 mrEMVI-positive patients at the time of diagnosis, 457 (78.3%) were EMVI-negative on surgical pathology, and they had significantly better 3-year OS, DMFS, DFS, and LRFS rates (all p < 0.001) than patients who remained EMVI-positive. After PSM was applied, patients receiving nCRT alone had significantly better 3-year OS (96.8% vs. 86.5%, p = 0.005) and DMFS (67.1% vs. 53.5%, p = 0.03) rates than those receiving NCT alone. Patients receiving NCT plus nCRT had higher pathological complete response (PCR) (10.8% vs. 2.7%, p = 0.04) and downstaging (33.8% vs. 5.3%, p < 0.001) rates than those receiving nCRT alone, but survival rates did not differ (all p > 0.05).
conclusionMost EMVI-positive patients with LARC converted to EMVI-negative after neoadjuvant treatment, resulting in improved OS and DFS. Patients receiving nCRT had more favorable survival outcomes than those receiving NCT, suggesting the importance of including neoadjuvant radiotherapy. Patients receiving NCT in addition to nCRT had higher rates of PCR and downstaging, but their survival rates were not better.
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