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Assessment of the prognostic factors for a local recurrence of rectal cancer: The utility of preoperative MR imaging

 Young Taik Oh  ;  Myeong-Jin Kim  ;  Joon Seok Lim  ;  Joo Hee Kim  ;  Kang Young Lee  ;  Nam Kyu Kim  ;  Won Ho Kim  ;  Ki Whang Kim 
 KOREAN JOURNAL OF RADIOLOGY, Vol.6(1) : 8-16, 2005 
Journal Title
Issue Date
Adult ; Aged ; Chi-Square Distribution ; Female ; Humans ; Lymphatic Metastasis ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Predictive Value of Tests ; Preoperative Care ; Prognosis ; Rectal Neoplasms/pathology* ; Rectal Neoplasms/surgery
Rectum, MR ; Rectum, neoplasms ; Rectum, surgery
OBJECTIVE: To determine the utility of MR imaging in evaluating the prognostic factors for a local recurrence of rectal cancer following a curative resection.
MATERIALS AND METHODS: The preoperative MR images obtained from 17 patients with a local recurrence and 54 patients without a local recurrence, who had undergone a curative resection, were independently evaluated by three radiologists. The following findings were analyzed: the direct invasion of the perirectal fat by the primary rectal carcinoma, involvement of the perirectal lymph nodes, perirectal spiculate nodules, perivascular encasement, and an enlargement of the pelvic wall lymph nodes. The clinical and surgical profiles were obtained from the patients' medical records. The association of a local recurrence with the MR findings and the clinicosurgical variables was statistically evaluated.
RESULTS: Of the MR findings, the presence of perivascular encasement (p = 0.001) and perirectal spiculate nodules (p = 0.001) were found to be significant prognostic factors for a local recurrence. Of the clinicosurgical profiles, the presence of a microscopic vascular invasion (p = 0.005) and the involvement of the regional lymph nodes (p = 0.006) were associated with a local recurrence. Logistic regression analysis showed that the presence of perirectal spiculate nodules was an independent predictor of a local recurrence (odds ratio, 7.382; 95% confidence interval, 1.438, 37.889; p = 0.017).
CONCLUSION: The presence of perirectal spiculate nodules and perivascular encasement on the preoperative MR images are significant predictors of a local recurrence after curative surgery for a rectal carcinoma. This suggests that preoperative MR imaging can provide useful information to help in the planning of preoperative adjuvant therapy.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Lee, Kang Young(이강영)
Lim, Joon Seok(임준석) ORCID logo https://orcid.org/0000-0002-0334-5042
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