ArticleBJS open2024
MRI-predicted extramural vascular invasion and tumour deposit are main predictors of disease-free survival in patients undergoing surgical resection for rectal cancer.
Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- The Prognostic Impact of Imaging Detected Tumor Deposits in Rectal Cancer: A Systematic Review and Meta-analysis.Annals of surgical oncology · 2026Pooled it
- CT-based abdominal fat parameters as predictors of recurrence-free survival after radical resection of colorectal cancer: a nomogram approach.Abdominal radiology (New York) · 2026Article
- MRI for Rectal Cancer: Updates and Controversies-AJR. American journal of roentgenology · 2025Review
- The Role of Predictive and Prognostic MRI-Based Biomarkers in the Era of Total Neoadjuvant Treatment in Rectal Cancer.Cancers · 2024Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMRI is crucial in staging patients with rectal cancer and planning treatment. The aim was to analyse the prognostic role of MRI-predicted tumour deposits and/or extramural vascular invasion (mrTD/EMVI) in a cohort of patients with rectal cancer undergoing surgical resection, with selective neoadjuvant chemoradiotherapy (nCRT).
methodRetrospective analysis of a single-centre cohort of consecutive patients with rectal cancer undergoing low anterior resection or abdominoperineal excision between 2008 and 2020. Unit policy was selective nCRT for MRI-predicted threatened or involved circumferential resection margin (mrCRM), or radiologically involved pelvic sidewall nodes. The primary outcome was disease-free survival. Secondary outcomes were rates of local recurrence, distant recurrence and overall survival.
resultsA total of 314 patients were analysed. Median age was 65 years (female/male: 114/200). A total of 54/314 (17%) had nCRT and 35 patients (11%) underwent abdominoperineal excision. Median follow-up was 64 months. Overall, local recurrence was detected in 18/314 (5.7%) and distant recurrence in 45/314 (14.3%). In patients not receiving nCRT (n = 260), local recurrence was detected in 11/260 (4.2%) and distant recurrence in 35/260 (13.5%). Disease-free survival was 80.5% at 5 years. Specifically, disease-free survival was 89% in mrTD/EMVI-negative and mrCRM-negative, 67% in mrTD/EMVI-positive and mrCRM-negative, and 64% in the mrCRM-positive rectal cancer (log-rank, P < 0.001). On multivariable Cox-regression analysis mrTD/EMVI was the only MRI variable associated with disease-free survival (hazard ratio 2.95; P < 0.001).
conclusionmrTD/EMVI is a major prognostic indicator. Rectal cancer patients with mrCRM-negative and mrTD/EMVI-negative have excellent long-term outcomes with surgery alone. Patients with mrTD/EMVI-positive should be selectively stratified for neoadjuvant treatments in future clinical trials.
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