Factors related to preoperative assessment of the circumferential resection margin and the extent of mesorectal invasion by magnetic resonance imaging in rectal cancer: A prospective comparison study

YoungWan Kim, Seung Whan Cha, Juyon Pyo, Namkyu Kim, Byung Soh Min, Myeong Jin Kim, Hoguen Kim

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: This study was designed to identify factors related to inaccurate prediction of circumferential resection margin (CRM) and the extent of mesorectal invasion (EMI) in T3 tumors by preoperative magnetic resonance imaging (MRI) in rectal cancer. Methods: A total of 66 patients with rectal cancer were enrolled prospectively in this study. CRM was defined as the distance from the outer tumor margin to the mesorectal fascia, and EMI was defined as the distance from the outer surface of the muscularis propria to the outermost tumor margin. CRM and EMI measurements on MRI were compared with corresponding measurements from whole-mount sections using 1-mm and 5-mm reference values, respectively, as prognostic indicators. The following variables were analyzed for relevance to preoperative staging: tumor distance from the anal verge (lower and middle), tumor location (anterior and posterior), tumor (T) and nodal (N) stage, and the thickness of the perirectal fat (anterior, left, right, and posterior positions). Results: MRI correctly predicted CRM status in 57 of the 66 tumors and EMI status in 51 of the 58 tumors (eight T1 tumors were excluded from EMI analysis). Univariate analysis showed that T3 stage, lymph node involvement, anterior tumor location, and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of CRM. Anterior tumor location and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of EMI. Conclusions: Preoperative chemoradiation can be accurately guided by preoperative MRI staging, but CRM and EMI in anterior rectal tumor should be interpreted with caution.

Original languageEnglish
Pages (from-to)1952-1960
Number of pages9
JournalWorld Journal of Surgery
Volume33
Issue number9
DOIs
Publication statusPublished - 2009 Sep 1

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Rectal Neoplasms
Magnetic Resonance Imaging
Prospective Studies
Neoplasms
Fats
Margins of Excision
Neoplasm Staging
Fascia
Reference Values
Lymph Nodes

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

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title = "Factors related to preoperative assessment of the circumferential resection margin and the extent of mesorectal invasion by magnetic resonance imaging in rectal cancer: A prospective comparison study",
abstract = "Background: This study was designed to identify factors related to inaccurate prediction of circumferential resection margin (CRM) and the extent of mesorectal invasion (EMI) in T3 tumors by preoperative magnetic resonance imaging (MRI) in rectal cancer. Methods: A total of 66 patients with rectal cancer were enrolled prospectively in this study. CRM was defined as the distance from the outer tumor margin to the mesorectal fascia, and EMI was defined as the distance from the outer surface of the muscularis propria to the outermost tumor margin. CRM and EMI measurements on MRI were compared with corresponding measurements from whole-mount sections using 1-mm and 5-mm reference values, respectively, as prognostic indicators. The following variables were analyzed for relevance to preoperative staging: tumor distance from the anal verge (lower and middle), tumor location (anterior and posterior), tumor (T) and nodal (N) stage, and the thickness of the perirectal fat (anterior, left, right, and posterior positions). Results: MRI correctly predicted CRM status in 57 of the 66 tumors and EMI status in 51 of the 58 tumors (eight T1 tumors were excluded from EMI analysis). Univariate analysis showed that T3 stage, lymph node involvement, anterior tumor location, and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of CRM. Anterior tumor location and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of EMI. Conclusions: Preoperative chemoradiation can be accurately guided by preoperative MRI staging, but CRM and EMI in anterior rectal tumor should be interpreted with caution.",
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Factors related to preoperative assessment of the circumferential resection margin and the extent of mesorectal invasion by magnetic resonance imaging in rectal cancer : A prospective comparison study. / Kim, YoungWan; Cha, Seung Whan; Pyo, Juyon; Kim, Namkyu; Min, Byung Soh; Kim, Myeong Jin; Kim, Hoguen.

In: World Journal of Surgery, Vol. 33, No. 9, 01.09.2009, p. 1952-1960.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors related to preoperative assessment of the circumferential resection margin and the extent of mesorectal invasion by magnetic resonance imaging in rectal cancer

T2 - A prospective comparison study

AU - Kim, YoungWan

AU - Cha, Seung Whan

AU - Pyo, Juyon

AU - Kim, Namkyu

AU - Min, Byung Soh

AU - Kim, Myeong Jin

AU - Kim, Hoguen

PY - 2009/9/1

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N2 - Background: This study was designed to identify factors related to inaccurate prediction of circumferential resection margin (CRM) and the extent of mesorectal invasion (EMI) in T3 tumors by preoperative magnetic resonance imaging (MRI) in rectal cancer. Methods: A total of 66 patients with rectal cancer were enrolled prospectively in this study. CRM was defined as the distance from the outer tumor margin to the mesorectal fascia, and EMI was defined as the distance from the outer surface of the muscularis propria to the outermost tumor margin. CRM and EMI measurements on MRI were compared with corresponding measurements from whole-mount sections using 1-mm and 5-mm reference values, respectively, as prognostic indicators. The following variables were analyzed for relevance to preoperative staging: tumor distance from the anal verge (lower and middle), tumor location (anterior and posterior), tumor (T) and nodal (N) stage, and the thickness of the perirectal fat (anterior, left, right, and posterior positions). Results: MRI correctly predicted CRM status in 57 of the 66 tumors and EMI status in 51 of the 58 tumors (eight T1 tumors were excluded from EMI analysis). Univariate analysis showed that T3 stage, lymph node involvement, anterior tumor location, and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of CRM. Anterior tumor location and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of EMI. Conclusions: Preoperative chemoradiation can be accurately guided by preoperative MRI staging, but CRM and EMI in anterior rectal tumor should be interpreted with caution.

AB - Background: This study was designed to identify factors related to inaccurate prediction of circumferential resection margin (CRM) and the extent of mesorectal invasion (EMI) in T3 tumors by preoperative magnetic resonance imaging (MRI) in rectal cancer. Methods: A total of 66 patients with rectal cancer were enrolled prospectively in this study. CRM was defined as the distance from the outer tumor margin to the mesorectal fascia, and EMI was defined as the distance from the outer surface of the muscularis propria to the outermost tumor margin. CRM and EMI measurements on MRI were compared with corresponding measurements from whole-mount sections using 1-mm and 5-mm reference values, respectively, as prognostic indicators. The following variables were analyzed for relevance to preoperative staging: tumor distance from the anal verge (lower and middle), tumor location (anterior and posterior), tumor (T) and nodal (N) stage, and the thickness of the perirectal fat (anterior, left, right, and posterior positions). Results: MRI correctly predicted CRM status in 57 of the 66 tumors and EMI status in 51 of the 58 tumors (eight T1 tumors were excluded from EMI analysis). Univariate analysis showed that T3 stage, lymph node involvement, anterior tumor location, and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of CRM. Anterior tumor location and thin perirectal fat thickness at the anterior portion were related to incorrect prediction of EMI. Conclusions: Preoperative chemoradiation can be accurately guided by preoperative MRI staging, but CRM and EMI in anterior rectal tumor should be interpreted with caution.

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