Xiaoyan Zhang1, Qiaoyuan Lu1, Xiangjie Guo2, Wuteng Cao3, Hongmei Zhang4, Tao Yu5, Xiaoting Li1, Zhen Guan1, Xueping Li1, Ruijia Sun1, Yingshi Sun1. 1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China. 2. Department of Forensic Medicine, Shanxi Medical University, Taiyuan 030001, China. 3. Department of Radiology, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510655, China. 4. Department of Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China. 5. Department of Medical Imaging, Cancer Hospital of China Medical University, Shenyang 110042, China.
Abstract
OBJECTIVE: To forward the magnetic resonance imaging (MRI) based distance between the deepest tumor invasion and mesorectal fascia (DMRF), and to explore its prognosis differentiation value in cT3 stage rectal cancer with comparison of cT3 substage. METHODS: This was a retrospective, multicenter cohort study including cT3 rectal cancer patients undergoing neoadjuvant chemoradiotherapy followed by radical surgery from January 2013 to September 2014. DMRF and cT3 substage were evaluated from baseline MRI. The cutoff of DMRF was determined by disease progression. Multivariate cox regression was used to test the prognostic values of baseline variables. RESULTS: A total of 804 patients were included, of which 226 (28.1%) developed progression. A DMRF cutoff of 7 mm was chosen. DMRF category, the clock position of the deepest position of tumor invasion (CDTI) and extramural venous invasion (EMVI) were independent predictors for disease progression, and hazard ratios (HRs) were 0.26 [95% confidence interval (95% CI), 0.13-0.56], 1.88 (95% CI, 1.33-2.65) and 1.57 (95% CI, 1.13-2.18), respectively. cT3 substage was not a predictor for disease progression. CONCLUSIONS: The measurement of DMRF value on baseline MRI can better distinguish cT3 rectal cancer prognosis rather than cT3 substage, and was recommended in clinical evaluation.
OBJECTIVE: To forward the magnetic resonance imaging (MRI) based distance between the deepest tumor invasion and mesorectal fascia (DMRF), and to explore its prognosis differentiation value in cT3 stage rectal cancer with comparison of cT3 substage. METHODS: This was a retrospective, multicenter cohort study including cT3 rectal cancer patients undergoing neoadjuvant chemoradiotherapy followed by radical surgery from January 2013 to September 2014. DMRF and cT3 substage were evaluated from baseline MRI. The cutoff of DMRF was determined by disease progression. Multivariate cox regression was used to test the prognostic values of baseline variables. RESULTS: A total of 804 patients were included, of which 226 (28.1%) developed progression. A DMRF cutoff of 7 mm was chosen. DMRF category, the clock position of the deepest position of tumor invasion (CDTI) and extramural venous invasion (EMVI) were independent predictors for disease progression, and hazard ratios (HRs) were 0.26 [95% confidence interval (95% CI), 0.13-0.56], 1.88 (95% CI, 1.33-2.65) and 1.57 (95% CI, 1.13-2.18), respectively. cT3 substage was not a predictor for disease progression. CONCLUSIONS: The measurement of DMRF value on baseline MRI can better distinguish cT3 rectal cancer prognosis rather than cT3 substage, and was recommended in clinical evaluation.
Authors: H J Schmoll; E Van Cutsem; A Stein; V Valentini; B Glimelius; K Haustermans; B Nordlinger; C J van de Velde; J Balmana; J Regula; I D Nagtegaal; R G Beets-Tan; D Arnold; F Ciardiello; P Hoff; D Kerr; C H Köhne; R Labianca; T Price; W Scheithauer; A Sobrero; J Tabernero; D Aderka; S Barroso; G Bodoky; J Y Douillard; H El Ghazaly; J Gallardo; A Garin; R Glynne-Jones; K Jordan; A Meshcheryakov; D Papamichail; P Pfeiffer; I Souglakos; S Turhal; A Cervantes Journal: Ann Oncol Date: 2012-10 Impact factor: 32.976
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