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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.

Authors
 Min Soo Cho  ;  Youn Young Park  ;  Jiho Yoon  ;  Seung Yoon Yang  ;  Seung Hyuk Baik  ;  Kang Young Lee  ;  Ik Yong Kim  ;  Nam Kyu Kim 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.117(8) : 1823-1832, 2018 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2018
MeSH
Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/therapy ; Chemoradiotherapy, Adjuvant ; Disease-Free Survival ; Female ; Humans ; Magnetic Resonance Imaging* ; Male ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local* ; Prognosis ; Rectal Neoplasms/diagnostic imaging* ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy* ; Retrospective Studies
Keywords
extramural vascular invasion status ; good tumor response ; rectal cancer ; tumor recurrence
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.
Full Text
https://onlinelibrary.wiley.com/doi/full/10.1002/jso.25064
DOI
10.1002/jso.25064
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Yang, Seung Yoon(양승윤) ORCID logo https://orcid.org/0000-0001-8129-7712
Lee, Kang Young(이강영)
Cho, Min Soo(조민수)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165365
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