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MRI Risk Stratification for Tumor Relapse in Rectal Cancer Achieving Pathological Complete Remission after Neoadjuvant Chemoradiation Therapy and Curative Resection

DC FieldValueLanguage
dc.contributor.author금웅섭-
dc.contributor.author김남규-
dc.contributor.author김명진-
dc.contributor.author김한솔-
dc.contributor.author안중배-
dc.contributor.author임준석-
dc.contributor.author허혁-
dc.date.accessioned2017-02-24T03:13:35Z-
dc.date.available2017-02-24T03:13:35Z-
dc.date.issued2016-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/146282-
dc.description.abstractPURPOSE: Rectal cancer patients achieving pCR are known to have an excellent prognosis, yet no widely accepted consensus on risk stratification and post-operative management (e.g., adjuvant therapy) has been established. This study aimed to identify magnetic resonance imaging (MRI) high-risk factors for tumor relapse in pathological complete remission (pCR) achieved by rectal cancer patients who have undergone neoadjuvant concurrent chemoradiation therapy (CRT) and curative resection. MATERIALS AND METHODS: We analyzed 88 (male/female = 55/33, median age, 59.5 years [range 34-78]) pCR-proven rectal cancer patients who had undergone pre-CRT MRI, CRT, post-CRT MRI and curative surgery between July 2005 and December 2012. Patients were observed for post-operative tumor relapse. We analyzed the pre/post-CRT MRIs for parameters including mrT stage, mesorectal fascia (mrMRF) status, tumor volume, tumor regression grade (mrTRG), nodal status (mrN), and extramural vessel invasion (mrEMVI). We performed univariate analysis and Kaplan-Meier survival analysis. RESULTS: Post-operative tumor relapse occurred in seven patients (8.0%, n = 7/88) between 5.7 and 50.7 (median 16.8) months. No significant relevance was observed between tumor volume, volume reduction rate, mrTRG, mrT, or mrN status. Meanwhile, positive mrMRF (Ppre-CRT = 0.018, Ppre/post-CRT = 0.006) and mrEMVI (Ppre-CRT = 0.026, Ppre-/post-CRT = 0.008) were associated with higher incidence of post-operative tumor relapse. Kaplan-Meier survival analysis revealed a higher risk of tumor relapse in patients with positive mrMRF (Ppre-CRT = 0.029, Ppre-/post-CRT = 0.009) or mrEMVI (Ppre-CRT = 0.024, Ppre-/post-CRT = 0.003). CONCLUSION: Positive mrMRF and mrEMVI status was associated with a higher risk of post-operative tumor relapse of pCR achieved by rectal cancer patients, and therefore, can be applied for risk stratification and to individualize treatment plans.-
dc.description.statementOfResponsibilityopen-
dc.format.extente0146235-
dc.languageEnglish-
dc.publisherPublic Library of Science-
dc.relation.isPartOfPLoS One-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAnalysis of Variance-
dc.subject.MESHChemoradiotherapy-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHMagnetic Resonance Imaging/methods*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHNeoadjuvant Therapy-
dc.subject.MESHNeoplasm Recurrence, Local-
dc.subject.MESHPostoperative Care/methods*-
dc.subject.MESHRectal Neoplasms/pathology*-
dc.subject.MESHRectal Neoplasms/therapy*-
dc.subject.MESHRectum/drug effects-
dc.subject.MESHRectum/radiation effects-
dc.subject.MESHRectum/surgery-
dc.subject.MESHRemission Induction-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Assessment/methods-
dc.subject.MESHRisk Factors-
dc.titleMRI Risk Stratification for Tumor Relapse in Rectal Cancer Achieving Pathological Complete Remission after Neoadjuvant Chemoradiation Therapy and Curative Resection-
dc.typeArticle-
dc.publisher.locationUnited States-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Radiation Oncology-
dc.contributor.googleauthorHonsoul Kim-
dc.contributor.googleauthorSungmin Myoung-
dc.contributor.googleauthorWoong Sub Koom-
dc.contributor.googleauthorNam Kyu Kim-
dc.contributor.googleauthorMyeong-Jin Kim-
dc.contributor.googleauthorJoong Bae Ahn-
dc.contributor.googleauthorHyuk Hur-
dc.contributor.googleauthorJoon Seok Lim-
dc.identifier.doi10.1371/journal.pone.0146235-
dc.contributor.localIdA00273-
dc.contributor.localIdA00353-
dc.contributor.localIdA00426-
dc.contributor.localIdA01099-
dc.contributor.localIdA02262-
dc.contributor.localIdA03408-
dc.contributor.localIdA04373-
dc.relation.journalcodeJ02540-
dc.identifier.eissn1932-6203-
dc.identifier.pmid26730717-
dc.contributor.alternativeNameKoom, Woong Sub-
dc.contributor.alternativeNameKim, Nam Kyu-
dc.contributor.alternativeNameKim, Myeong Jin-
dc.contributor.alternativeNameKim, Hon Soul-
dc.contributor.alternativeNameAhn, Joong Bae-
dc.contributor.alternativeNameLim, Joon Seok-
dc.contributor.alternativeNameHur, Hyuk-
dc.contributor.affiliatedAuthorKoom, Woong Sub-
dc.contributor.affiliatedAuthorKim, Nam Kyu-
dc.contributor.affiliatedAuthorKim, Myeong Jin-
dc.contributor.affiliatedAuthorKim, Hon Soul-
dc.contributor.affiliatedAuthorAhn, Joong Bae-
dc.contributor.affiliatedAuthorLim, Joon Seok-
dc.contributor.affiliatedAuthorHur, Hyuk-
dc.citation.volume11-
dc.citation.number1-
dc.citation.startPagee0146235-
dc.identifier.bibliographicCitationPLoS One, Vol.11(1) : e0146235, 2016-
dc.date.modified2017-02-24-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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