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MRI morphologic and clinicopathologic characteristics for predicting outcomes in patients with locally advanced rectal cancer

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Abstract

Purpose

The aim of this study was to investigate the value of MRI morphologic and clinicopathologic factors for predicting 3-year disease-free survival (DFS) in patients with locally advanced rectal cancer (LARC).

Method

In this retrospective study, pre- and post-neoadjuvant chemoradiotherapy (nCRT) MRI morphologic (e.g., pre-nCRT MRI-detected extramural venous invasion) and clinicopathologic variabilities (e.g., pathological complete response) were evaluated in all patients. Three-year DFS was estimated using Kaplan–Meier product-limit method, and Cox proportional hazards models were used to determine associations between morphologic or clinicopathologic variabilities and survival outcomes.

Results

A total of 115 patients (39 females and 76 males; median age, 54 years; age range, 28–82 years) with LARC treated with nCRT were enrolled. With a median follow-up of 48.0 months, the 3-year DFS was 79.0% for all patients. During follow-up, 18 patients died, 28 patients experienced relapse (26 distant, one local, and one both), and 69 patients were censored. MRI-detected extramural venous invasion (mrEMVI) was the only significantly independent factor of long-term survival, while HR was 2.308 (95% CI 1.151–4.629, P = 0.018) on univariate and 2.495 (95% CI 1.243–5.012, P = 0.010) on multivariate analysis. The 3-year cumulative survival rate in patients with mrEMVI negativity compared with positivity were 86.6% versus 65.0% (P = 0.015), respectively.

Conclusion

In conclusion, pre-nCRT mrEMVI status was the independent significant risk factor for long-term outcomes in LARC patients treated with nCRT, while the other morphologic and clinicopathologic characteristics were not related to the patient survival.

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Funding

This work was supported by the Beijing Science and Technology Program (Z161100000516101), Beijing Hope Run Special Fund of Cancer Foundation of China (LC2016A05), and National Key research and development program of the Ministry of Science and Technology of China (2016YFC0905303).

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Author notes

  1. Chunwu Zhou and Hongmei Zhang have contributed equally to this article.

Authors and Affiliations

  1. Department of Radiology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Panjiayuannanli, Chaoyang District, Beijing, 100021, People’s Republic of China

    Yankai Meng, Lijuan Wan, Feng Ye, Chongda Zhang, Xinming Zhao, Hongmei Zhang & Chunwu Zhou

  2. Department of Pathology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China

    Shuangmei Zou

  3. Department of Radiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, People’s Republic of China

    Yankai Meng & Kai Xu

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  1. Yankai Meng
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Meng, Y., Wan, L., Ye, F. et al. MRI morphologic and clinicopathologic characteristics for predicting outcomes in patients with locally advanced rectal cancer. Abdom Radiol 44, 3652–3663 (2019). https://doi.org/10.1007/s00261-018-1828-1

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