ArticleIndian journal of surgical oncology2026
Baseline Magnetic Resonance Imaging Assessment of Circumferential Resection Margin Predicts Long-term Survival in Rectal Adenocarcinoma: Experience from a Tertiary Care Center.
Article in Indian journal of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
In rectal adenocarcinoma, the diagnostic accuracy of baseline MRI for predicting circumferential resection margin (CRM) is established. However, data regarding the role of baseline and post-neoadjuvant chemoradiotherapy (NACTRT) MRI-mesorectal fascia (MRI-MRF)-positive status in predicting long-term oncological outcomes is relatively scarce and heterogeneous. The objective of the study is to evaluate the long-term oncological survival outcomes of baseline and post-neoadjuvant chemoradiation (NACTRT) MRI-MRF as predictors of long-term survival outcomes, i.e., overall survival (OS), disease-free survival (DFS), and locoregional recurrence-free survival (LRFS). Single center retrospective analysis from a prospectively maintained database. Patients undergoing curative surgery for rectal adenocarcinoma either upfront or post-NACTRT between July 2013 and April 2014. Patients with cT3/cT4 or N + received NACTRT before surgery. The pre-NACTRT MRI was recorded as MRI 1-MRF and post-NACTRT MRI was recorded as MRI 2-MRF. MRI scans done at presentation irrespective of further treatment were labeled as MRI T-MRF. Out of 254 patients, 217 were eligible for analysis. The median follow-up duration is 132 months. Seventy-six percent of patients received NACTRT. Overall, recurrences were seen in 68/217 (31.3%) patients, with 18 local and 50 distant recurrences. Eighty-six (39.6%) deaths were recorded, most due to disease progression. The 5-year OS of the cohort was 69.1% (95% C.I 63-75.8); 5-year DFS was 67.4% (95% C.I 61.2-74.3); and the 5-year LRFS was 91% (95% C.I 87-95.2). MRI T-MRF status was significantly associated in predicting OS, DFS, and LRFS. MRI 1-MRF status is a strong predictor for OS and DFS. The MRI 2-MRF status is a weak predictor for OS and is not associated with DFS and LRFS. The path-CRM-positive status is a significant predictor of OS and DFS, however not for LRFS. Baseline MRI-MRF status is a robust and strong predictor of long-term survival outcomes (OS, DFS, LRFS). Patients with baseline MRI-CRM-positive status have poorer outcomes irrespective of neoadjuvant therapy and poor histology features.
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