MRI-based EMVI positivity predicts systemic recurrence in rectal cancer patients with a good tumor response to chemoradiotherapy followed by surgery

Min Soo Cho, Youn Young Park, Jiho Yoon, Seung Yoon Yang, Seung Hyuk Baik, Kang Young Lee, Ikyong Kim, Namkyu Kim

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Abstract

Background: This study aimed to determine the prognostic value of baseline magnetic resonance imaging-based extramural vascular invasion status (EMVI) among rectal cancer patients with a good tumor response to standard chemoradiotherapy followed by surgery. Methods: A total of 359 patients with ypT0-2/N0 disease from The Yonsei Multicenter Colorectal Cancer Electronic Database were retrospectively included between January 2000 and December 2014. Magnetic resonance images and medical records were reviewed to investigate risk factors for tumor recurrence. Results: When we compared patients without and with EMVI, significant differences were observed in the 5-year disease-free survival rate (DFS) (80.8% vs 57.8%, P = 0.005) and in the 5-year systemic recurrence-free survival rate (SRFS) (86.9% vs 64.3%, P = 0.007). In the multivariate analysis, both mrEMVI and APR independently predicted overall DFS (APR; HR 2.088, 95% CI: 1.082-4.031, P = 0.028, mrEMVI; HR: 2.729, 95% CI: 1.230-6.058, P = 0.014). mrEMVI was only independent prognostic factor for systemic recurrence with statistical significance (HR: 3.321, 95% CI: 1.185-9.309, P = 0.022). Conclusion: Even in rectal cancer patients with a good response to chemoradiotherapy followed by curative surgery, extramural vascular invasion and APR may predict poor disease-free survival outcomes. Intensified treatment strategy should be considered.

Original languageEnglish
Pages (from-to)1823-1832
Number of pages10
JournalJournal of surgical oncology
Volume117
Issue number8
DOIs
Publication statusPublished - 2018 Jun 15

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Chemoradiotherapy
Rectal Neoplasms
Blood Vessels
Disease-Free Survival
Recurrence
Survival Rate
Neoplasms
Medical Records
Colorectal Neoplasms
Magnetic Resonance Spectroscopy
Multivariate Analysis
Magnetic Resonance Imaging
Databases
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Cho, Min Soo ; Park, Youn Young ; Yoon, Jiho ; Yang, Seung Yoon ; Baik, Seung Hyuk ; Lee, Kang Young ; Kim, Ikyong ; Kim, Namkyu. / MRI-based EMVI positivity predicts systemic recurrence in rectal cancer patients with a good tumor response to chemoradiotherapy followed by surgery. In: Journal of surgical oncology. 2018 ; Vol. 117, No. 8. pp. 1823-1832.
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title = "MRI-based EMVI positivity predicts systemic recurrence in rectal cancer patients with a good tumor response to chemoradiotherapy followed by surgery",
abstract = "Background: This study aimed to determine the prognostic value of baseline magnetic resonance imaging-based extramural vascular invasion status (EMVI) among rectal cancer patients with a good tumor response to standard chemoradiotherapy followed by surgery. Methods: A total of 359 patients with ypT0-2/N0 disease from The Yonsei Multicenter Colorectal Cancer Electronic Database were retrospectively included between January 2000 and December 2014. Magnetic resonance images and medical records were reviewed to investigate risk factors for tumor recurrence. Results: When we compared patients without and with EMVI, significant differences were observed in the 5-year disease-free survival rate (DFS) (80.8{\%} vs 57.8{\%}, P = 0.005) and in the 5-year systemic recurrence-free survival rate (SRFS) (86.9{\%} vs 64.3{\%}, P = 0.007). In the multivariate analysis, both mrEMVI and APR independently predicted overall DFS (APR; HR 2.088, 95{\%} CI: 1.082-4.031, P = 0.028, mrEMVI; HR: 2.729, 95{\%} CI: 1.230-6.058, P = 0.014). mrEMVI was only independent prognostic factor for systemic recurrence with statistical significance (HR: 3.321, 95{\%} CI: 1.185-9.309, P = 0.022). Conclusion: Even in rectal cancer patients with a good response to chemoradiotherapy followed by curative surgery, extramural vascular invasion and APR may predict poor disease-free survival outcomes. Intensified treatment strategy should be considered.",
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MRI-based EMVI positivity predicts systemic recurrence in rectal cancer patients with a good tumor response to chemoradiotherapy followed by surgery. / Cho, Min Soo; Park, Youn Young; Yoon, Jiho; Yang, Seung Yoon; Baik, Seung Hyuk; Lee, Kang Young; Kim, Ikyong; Kim, Namkyu.

In: Journal of surgical oncology, Vol. 117, No. 8, 15.06.2018, p. 1823-1832.

Research output: Contribution to journalArticle

TY - JOUR

T1 - MRI-based EMVI positivity predicts systemic recurrence in rectal cancer patients with a good tumor response to chemoradiotherapy followed by surgery

AU - Cho, Min Soo

AU - Park, Youn Young

AU - Yoon, Jiho

AU - Yang, Seung Yoon

AU - Baik, Seung Hyuk

AU - Lee, Kang Young

AU - Kim, Ikyong

AU - Kim, Namkyu

PY - 2018/6/15

Y1 - 2018/6/15

N2 - Background: This study aimed to determine the prognostic value of baseline magnetic resonance imaging-based extramural vascular invasion status (EMVI) among rectal cancer patients with a good tumor response to standard chemoradiotherapy followed by surgery. Methods: A total of 359 patients with ypT0-2/N0 disease from The Yonsei Multicenter Colorectal Cancer Electronic Database were retrospectively included between January 2000 and December 2014. Magnetic resonance images and medical records were reviewed to investigate risk factors for tumor recurrence. Results: When we compared patients without and with EMVI, significant differences were observed in the 5-year disease-free survival rate (DFS) (80.8% vs 57.8%, P = 0.005) and in the 5-year systemic recurrence-free survival rate (SRFS) (86.9% vs 64.3%, P = 0.007). In the multivariate analysis, both mrEMVI and APR independently predicted overall DFS (APR; HR 2.088, 95% CI: 1.082-4.031, P = 0.028, mrEMVI; HR: 2.729, 95% CI: 1.230-6.058, P = 0.014). mrEMVI was only independent prognostic factor for systemic recurrence with statistical significance (HR: 3.321, 95% CI: 1.185-9.309, P = 0.022). Conclusion: Even in rectal cancer patients with a good response to chemoradiotherapy followed by curative surgery, extramural vascular invasion and APR may predict poor disease-free survival outcomes. Intensified treatment strategy should be considered.

AB - Background: This study aimed to determine the prognostic value of baseline magnetic resonance imaging-based extramural vascular invasion status (EMVI) among rectal cancer patients with a good tumor response to standard chemoradiotherapy followed by surgery. Methods: A total of 359 patients with ypT0-2/N0 disease from The Yonsei Multicenter Colorectal Cancer Electronic Database were retrospectively included between January 2000 and December 2014. Magnetic resonance images and medical records were reviewed to investigate risk factors for tumor recurrence. Results: When we compared patients without and with EMVI, significant differences were observed in the 5-year disease-free survival rate (DFS) (80.8% vs 57.8%, P = 0.005) and in the 5-year systemic recurrence-free survival rate (SRFS) (86.9% vs 64.3%, P = 0.007). In the multivariate analysis, both mrEMVI and APR independently predicted overall DFS (APR; HR 2.088, 95% CI: 1.082-4.031, P = 0.028, mrEMVI; HR: 2.729, 95% CI: 1.230-6.058, P = 0.014). mrEMVI was only independent prognostic factor for systemic recurrence with statistical significance (HR: 3.321, 95% CI: 1.185-9.309, P = 0.022). Conclusion: Even in rectal cancer patients with a good response to chemoradiotherapy followed by curative surgery, extramural vascular invasion and APR may predict poor disease-free survival outcomes. Intensified treatment strategy should be considered.

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U2 - 10.1002/jso.25064

DO - 10.1002/jso.25064

M3 - Article

VL - 117

SP - 1823

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JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

SN - 0022-4790

IS - 8

ER -