The prognostic significance of MRI-detected extramural venous invasion in rectal carcinoma

Bugg, William; Andreou, Adrian; Biswas, Debabrata; Toms, Andoni P.; Williams, S. M.

doi:10.1016/j.crad.2014.01.010

Cited by 101 publications

(71 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several reports have shown that pathologic EMVI correlates significantly with metachronous metastases [9,10] and we believe that MRI-detected EMVI would also be a risk factor for metachronous distant tumour spread. Recently, Bugg et al showed that MRI-detected EMVI are associated with an increased metachronous metastases within 1 year of diagnosis [33]. Second, not every patient in this study underwent liver MRI or FDG-PET/CT, and there is a possibility that we missed some metastases.…”

Section: Discussionmentioning

confidence: 84%

MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer

et al. 2014

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 84%

MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Postsurgical recurrence of rectal cancer was also shown to differ according to MRI-predicted EMVI status in one study: 3-year recurrence-free survival of 35% in patients with EMVI-positive findings on MRI compared with 74% in EMVI-negative patients (60). Tumor extension into the extramural veins may provide a pathway of hematogenous dissemination of the tumor cells and would explain the reason why EMVI is a risk factor for synchronous or metachronous metastasis in patients with rectal cancer (6162). EMVI is currently not considered for TNM staging of a rectal cancer, one reason for which is presumably the highly variable reported prevalence (9–61% (59)), which may indicate inconsistent recognition and reporting of the findings.…”

Section: Elaboration On the Reporting Items Formats And Their Clinimentioning

confidence: 99%

Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

2017

Korean J Radiol

View full text Add to dashboard Cite

High-resolution rectal MRI plays a crucial role in evaluating rectal cancer by providing multiple prognostic findings and imaging features that guide proper patient management. Quality reporting is critical for accurate effective communication of the information among multiple disciplines, for which a systematic structured approach is beneficial. Existing guides on reporting of rectal MRI are divergent on some issues, largely reflecting the differences in overall management of rectal cancer patients between the United States and Europe. The Korean Society of Abdominal Radiology (KSAR) study group for rectal cancer has developed an expert consensus recommendation regarding essential items for structured reporting of rectal cancer MRI using a modified Delphi method. This recommendation aims at presenting an up-to-date, evidence-based, practical, structured reporting template that can be readily adopted in daily clinical practice. In addition, a thorough explanation of the clinical and scientific rationale underlying the reporting items and their formats is provided. This KSAR recommendation may serve as a useful tool to help achieve more standardized optimal care for rectal cancer patients using rectal MRI.

show abstract

“…Furthermore, the presence of EMVI has a relative risk of 3.7 for the development of systemic recurrence when detectable on preoperative MRI scanning[15]. The role of EMVI in directing treatment is relatively new and not well established.…”

Section: Introductionmentioning

confidence: 99%

Extramural vascular invasion and response to neoadjuvant chemoradiotherapy in rectal cancer: Influence of the CpG island methylator phenotype

Williamson¹,

Jones²,

Williams³

et al. 2017

WJGO

View full text Add to dashboard Cite

AIMTo identify whether CpG island methylator phenotype (CIMP) is predictive of response to neoadjuvant chemoradiotherapy (NACRT) and outcomes in rectal cancer.METHODSPatients undergoing NACRT and surgical resection for rectal cancer in a tertiary referral centre between 2002-2011 were identified. Pre-treatment tumour biopsies were analysed for CIMP status (high, intermediate or low) using methylation specific PCR. KRAS and BRAF status were also determined using pyrosequencing analysis. Clinical information was extracted from case records and cancer services databases. Response to radiotherapy was measured by tumour regression scores determined upon histological examination of the resected specimen. The relationship between these molecular features, response to NACRT and oncological outcomes were analysed.RESULTSThere were 160 patients analysed with a median follow-up time of 46.4 mo. Twenty-one (13%) patients demonstrated high levels of CIMP methylation (CIMP-H) and this was significantly associated with increased risk of extramural vascular invasion (EMVI) compared with CIMP-L [8/21 (38%) vs 15/99 (15%), P = 0.028]. CIMP status was not related to tumour regression after radiotherapy or survival, however EMVI was significantly associated with adverse survival (P < 0.001). Intermediate CIMP status was significantly associated with KRAS mutation (P = 0.01). There were 14 (9%) patients with a pathological complete response (pCR) compared to 116 (73%) patients having no or minimal regression after neoadjuvant chemoradiotherapy. Those patients with pCR had median survival of 106 mo compared to 65.8 mo with minimal regression, although this was not statistically significant (P = 0.26). Binary logistic regression analysis of the relationship between EMVI and other prognostic features revealed, EMVI positivity was associated with poor overall survival, advanced “T” stage and CIMP-H but not nodal status, age, sex, KRAS mutation status and presence of local or systemic recurrence.CONCLUSIONWe report a novel association of pre-treatment characterisation of CIMP-H with EMVI status which has prognostic implications and is not readily detectable on pre-treatment histological examination.

show abstract

The prognostic significance of MRI-detected extramural venous invasion in rectal carcinoma

Cited by 101 publications

References 23 publications

MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer

MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer

Essential Items for Structured Reporting of Rectal Cancer MRI: 2016 Consensus Recommendation from the Korean Society of Abdominal Radiology

Extramural vascular invasion and response to neoadjuvant chemoradiotherapy in rectal cancer: Influence of the CpG island methylator phenotype

Contact Info

Product

Resources

About