Prognostic significance of MR identified EMVI, tumour deposits, mesorectal nodes and pelvic side wall disease in locally advanced rectal cancer

• DOI: 10.1111/codi.16032
• Publication Date: 2021-12-26T07:39:21Z
• Authors: Anuradha Chandram...; Rohin Mittal; Romina Dsouza; Harish Yezzaji; Anu Eapen; Betty Simon; Reetu John; Ashish Singh; Thomas S. Ram; Mark R. Jesudason; Dipti Masih; Reka Karuppusami
• Keywords: T-stage; Chemoradiotherapy; Clinical Significance

To study the prognostic significance of MRI identified tumour deposits (TD), extramural vascular invasion (EMVI), lymph node metastases (LNM) and pelvic sidewall (PSW) disease in rectal cancer.This IRB approved was conducted on patients with stage IIA-IIIC adenocarcinoma treated neoadjuvant long course chemoradiotherapy (LCCRT) total mesorectal excision (TME) type surgery between 2012-2018. A radiologist blinded to outcome reviewed staging restaging magnetic resonance imaging (MRI) for TD, EMVI, LNM PSW. The agreement four radiologists studied we obtained data from a prospectively maintained database. findings assessed.A 297 (186 males) mean age 47.3 (SD14.4) years were included study. majority had T3 (n = 206) or T4 59) disease. duration follow-up 49.3 ± 25 months (6.6-101 months). 5-year overall (OS) disease-free survival (DFS) 84% 74%, respectively. Staging EMVI 49.5% 31.3%; TD 47.5% 31.6%; 61.1% 38.1% PSW 11.4% 6.1%. OS adversely affected by adjusted HR (aHR) 3.32, 3.31, 3.27 2.99, 3.1, 2.81 MRI, respectively, p < 0.05. DFS (aHR 1.85, 2.33) 1.83, 2.19), Persistence these after LCCRT led worst outcome. Intra- interobserver LN 0.789, 0.734, 0.406 0.449, 0.354, 0.376, 0.001.MRI that are independent poor indicators cancer patients. Interobserver moderate fair.