Toshinori Sueda1, Masayuki Ohue2, Shingo Noura1, Tatsushi Shingai1, Katsuyuki Nakanishi3, Masahiko Yano1. 1. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan. 2. Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan. ohue-ma@mc.pref.osaka.jp. 3. Department of Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3, Nakamichi, Higashinari-ku, Osaka, 537-8511, Japan.
Abstract
PURPOSES: The aim of this study was to evaluate the association between the mesorectal extensions on high-resolution magnetic resonance imaging (MRI) and the prognosis of patients with clinical T3 lower rectal cancer. METHODS: Fifty-eight patients with clinical T3 lower rectal cancer were investigated using high-resolution MRI. One radiologist who was blinded to the clinicopathological findings retrospectively examined the MRI-predicted circumferential resection margin (mrCRM) and the distance of mesorectal extension (mrDME) on the scans. If the imaging showed a tumor ≤1 mm from the mesorectal fascia, then the mrCRM involvement was defined as potentially present. The tumors were divided into two groups: mrDME ≤4 mm and mrDME >4 mm. RESULTS: A survival analysis showed that mrCRM-positive patients had a significantly poorer prognosis in the RFS (p < 0.01) and LRFS (p < 0.01). Patients with mrDME >4 mm revealed a significantly poorer prognosis than those with mrDME ≤4 mm in the OS (p = 0.04), RFS (p < 0.01), and LRFS (p = 0.04). A multivariate analysis revealed that both mrCRM and mrDME on MRI had a significant impact on the RFS (p = 0.01 and 0.03, respectively). CONCLUSION: The mrDME, as well as the mrCRM, may be an important preoperative prognostic factor for patients with clinical T3 lower rectal cancer.
PURPOSES: The aim of this study was to evaluate the association between the mesorectal extensions on high-resolution magnetic resonance imaging (MRI) and the prognosis of patients with clinical T3 lower rectal cancer. METHODS: Fifty-eight patients with clinical T3 lower rectal cancer were investigated using high-resolution MRI. One radiologist who was blinded to the clinicopathological findings retrospectively examined the MRI-predicted circumferential resection margin (mrCRM) and the distance of mesorectal extension (mrDME) on the scans. If the imaging showed a tumor ≤1 mm from the mesorectal fascia, then the mrCRM involvement was defined as potentially present. The tumors were divided into two groups: mrDME ≤4 mm and mrDME >4 mm. RESULTS: A survival analysis showed that mrCRM-positive patients had a significantly poorer prognosis in the RFS (p < 0.01) and LRFS (p < 0.01). Patients with mrDME >4 mm revealed a significantly poorer prognosis than those with mrDME ≤4 mm in the OS (p = 0.04), RFS (p < 0.01), and LRFS (p = 0.04). A multivariate analysis revealed that both mrCRM and mrDME on MRI had a significant impact on the RFS (p = 0.01 and 0.03, respectively). CONCLUSION: The mrDME, as well as the mrCRM, may be an important preoperative prognostic factor for patients with clinical T3 lower rectal cancer.
Entities:
Keywords:
Circumferential resection margin; Distance of mesorectal extension; Lower rectal cancer; Magnetic resonance imaging
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