View in EDS

Prognostic Implications of MRI-Detected EMVI and Tumor Deposits and Their Response to Neoadjuvant Therapy in cT3 and cT4 Rectal Cancer.

Saved in:
Bibliographic Details
Title: Prognostic Implications of MRI-Detected EMVI and Tumor Deposits and Their Response to Neoadjuvant Therapy in cT3 and cT4 Rectal Cancer.
Authors: Schaap, Dennis P.1 (AUTHOR), Voogt, Eva L.K.1 (AUTHOR), Burger, Jacobus W.A.1 (AUTHOR), Cnossen, Jeltsje S.2 (AUTHOR), Creemers, Geert-Jan M.3 (AUTHOR), van Lijnschoten, Ineke4 (AUTHOR), Nieuwenhuijzen, Grard A.P.1 (AUTHOR), Rutten, Harm J.T.1,5 (AUTHOR), Daniels-Gooszen, Alette W.6 (AUTHOR), Nederend, Joost6 (AUTHOR), Kusters, Miranda1,7 (AUTHOR) m.kusters@amsterdamumc.nl
Source: International Journal of Radiation Oncology, Biology, Physics. Nov2021, Vol. 111 Issue 3, p816-825. 10p.
Subjects: Rectal cancer, Oncologic surgery, Magnetic resonance, Cancer treatment, Tumors, Rectum tumors, Cancer invasiveness, Prognosis, Retrospective studies, Magnetic resonance imaging, Combined modality therapy
Abstract: Purpose: Magnetic resonance imaging-detected extramural venous invasion (mrEMVI) and tumor deposits (TDs) are risk factors for the development of local recurrence and distant metastases (DMs) in rectal cancer. However, little is known about their response to neoadjuvant treatment and its relation to oncologic outcomes. This study evaluated the incidence and features of mrEMVI and TDs before and after neoadjuvant treatment in relation to the development of local recurrence and DMs.Methods and Materials: Patients with cT3/4 rectal cancer without synchronous metastases who underwent surgery in a tertiary referral hospital were retrospectively analyzed. MRI scans were re-evaluated for the presence of mrEMVI, the occurrence of TDs, and response to neoadjuvant therapy (mr-vTRG).Results: In total, 277 patients were included, of whom 163 (58.8%) presented with mrEMVI. TDs were present in 56.4% of mrEMVI-positive and 9.6% of mrEMVI-negative patients (P < .001). The 5-year DM rate was significantly higher in mrEMVI-positive patients with and without TDs (45.2% and 35.9%, respectively) compared with mrEMVI-negative patients (25.7%; P = .012). After neoadjuvant treatment, the 5-year DM rate of patients with mr-vTRG 3-5 was 46.1%, whereas good responders (mr-vTRG 1-2) had a DM rate similar to mrEMVI-negative patients (25.7% and 25.7%, respectively; P = .002). The occurrence of TDs and larger mrEMVI size resulted in a lower likelihood of regression of mrEMVI.Conclusions: The prevalence of mrEMVI and TDs in cT3-4 rectal cancer is high and is associated with worsened oncologic outcomes. mrEMVI regression (mr-vTRG 1-2), which occured in 25% of the cases, leads to oncologic outcomes similar to those in patients without mrEMVI on baseline MRI. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Engineering Source
FullText Text:
  Availability: 0
Header DbId: egs
DbLabel: Engineering Source
An: 152366093
AccessLevel: 6
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Prognostic Implications of MRI-Detected EMVI and Tumor Deposits and Their Response to Neoadjuvant Therapy in cT3 and cT4 Rectal Cancer.
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Schaap%2C+Dennis+P%2E%22&quot;&gt;Schaap, Dennis P.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Voogt%2C+Eva+L%2EK%2E%22&quot;&gt;Voogt, Eva L.K.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burger%2C+Jacobus+W%2EA%2E%22&quot;&gt;Burger, Jacobus W.A.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cnossen%2C+Jeltsje+S%2E%22&quot;&gt;Cnossen, Jeltsje S.&lt;/searchLink&gt;&lt;relatesTo&gt;2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Creemers%2C+Geert-Jan+M%2E%22&quot;&gt;Creemers, Geert-Jan M.&lt;/searchLink&gt;&lt;relatesTo&gt;3&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22van+Lijnschoten%2C+Ineke%22&quot;&gt;van Lijnschoten, Ineke&lt;/searchLink&gt;&lt;relatesTo&gt;4&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nieuwenhuijzen%2C+Grard+A%2EP%2E%22&quot;&gt;Nieuwenhuijzen, Grard A.P.&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rutten%2C+Harm+J%2ET%2E%22&quot;&gt;Rutten, Harm J.T.&lt;/searchLink&gt;&lt;relatesTo&gt;1,5&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Daniels-Gooszen%2C+Alette+W%2E%22&quot;&gt;Daniels-Gooszen, Alette W.&lt;/searchLink&gt;&lt;relatesTo&gt;6&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nederend%2C+Joost%22&quot;&gt;Nederend, Joost&lt;/searchLink&gt;&lt;relatesTo&gt;6&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kusters%2C+Miranda%22&quot;&gt;Kusters, Miranda&lt;/searchLink&gt;&lt;relatesTo&gt;1,7&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; m.kusters@amsterdamumc.nl&lt;/i&gt;
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22&quot;&gt;International Journal of Radiation Oncology, Biology, Physics&lt;/searchLink&gt;. Nov2021, Vol. 111 Issue 3, p816-825. 10p.
– Name: Subject
  Label: Subjects
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Rectal+cancer%22&quot;&gt;Rectal cancer&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Oncologic+surgery%22&quot;&gt;Oncologic surgery&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Magnetic+resonance%22&quot;&gt;Magnetic resonance&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cancer+treatment%22&quot;&gt;Cancer treatment&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Tumors%22&quot;&gt;Tumors&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Rectum+tumors%22&quot;&gt;Rectum tumors&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cancer+invasiveness%22&quot;&gt;Cancer invasiveness&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Prognosis%22&quot;&gt;Prognosis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Retrospective+studies%22&quot;&gt;Retrospective studies&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Magnetic+resonance+imaging%22&quot;&gt;Magnetic resonance imaging&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Combined+modality+therapy%22&quot;&gt;Combined modality therapy&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: &lt;bold&gt;Purpose: &lt;/bold&gt;Magnetic resonance imaging-detected extramural venous invasion (mrEMVI) and tumor deposits (TDs) are risk factors for the development of local recurrence and distant metastases (DMs) in rectal cancer. However, little is known about their response to neoadjuvant treatment and its relation to oncologic outcomes. This study evaluated the incidence and features of mrEMVI and TDs before and after neoadjuvant treatment in relation to the development of local recurrence and DMs.&lt;bold&gt;Methods and Materials: &lt;/bold&gt;Patients with cT3/4 rectal cancer without synchronous metastases who underwent surgery in a tertiary referral hospital were retrospectively analyzed. MRI scans were re-evaluated for the presence of mrEMVI, the occurrence of TDs, and response to neoadjuvant therapy (mr-vTRG).&lt;bold&gt;Results: &lt;/bold&gt;In total, 277 patients were included, of whom 163 (58.8%) presented with mrEMVI. TDs were present in 56.4% of mrEMVI-positive and 9.6% of mrEMVI-negative patients (P &lt; .001). The 5-year DM rate was significantly higher in mrEMVI-positive patients with and without TDs (45.2% and 35.9%, respectively) compared with mrEMVI-negative patients (25.7%; P&#160;=&#160;.012). After neoadjuvant treatment, the 5-year DM rate of patients with mr-vTRG 3-5 was 46.1%, whereas good responders (mr-vTRG 1-2) had a DM rate similar to mrEMVI-negative patients (25.7% and 25.7%, respectively; P&#160;=&#160;.002). The occurrence of TDs and larger mrEMVI size resulted in a lower likelihood of regression of mrEMVI.&lt;bold&gt;Conclusions: &lt;/bold&gt;The prevalence of mrEMVI and TDs in cT3-4 rectal cancer is high and is associated with worsened oncologic outcomes. mrEMVI regression (mr-vTRG 1-2), which occured in 25% of the cases, leads to oncologic outcomes similar to those in patients without mrEMVI on baseline MRI. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: &lt;i&gt;Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=152366093
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1016/j.ijrobp.2021.06.013
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 10
        StartPage: 816
    Subjects:
      – SubjectFull: Rectal cancer
        Type: general
      – SubjectFull: Oncologic surgery
        Type: general
      – SubjectFull: Magnetic resonance
        Type: general
      – SubjectFull: Cancer treatment
        Type: general
      – SubjectFull: Tumors
        Type: general
      – SubjectFull: Rectum tumors
        Type: general
      – SubjectFull: Cancer invasiveness
        Type: general
      – SubjectFull: Prognosis
        Type: general
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Magnetic resonance imaging
        Type: general
      – SubjectFull: Combined modality therapy
        Type: general
    Titles:
      – TitleFull: Prognostic Implications of MRI-Detected EMVI and Tumor Deposits and Their Response to Neoadjuvant Therapy in cT3 and cT4 Rectal Cancer.
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Schaap, Dennis P.
      – PersonEntity:
          Name:
            NameFull: Voogt, Eva L.K.
      – PersonEntity:
          Name:
            NameFull: Burger, Jacobus W.A.
      – PersonEntity:
          Name:
            NameFull: Cnossen, Jeltsje S.
      – PersonEntity:
          Name:
            NameFull: Creemers, Geert-Jan M.
      – PersonEntity:
          Name:
            NameFull: van Lijnschoten, Ineke
      – PersonEntity:
          Name:
            NameFull: Nieuwenhuijzen, Grard A.P.
      – PersonEntity:
          Name:
            NameFull: Rutten, Harm J.T.
      – PersonEntity:
          Name:
            NameFull: Daniels-Gooszen, Alette W.
      – PersonEntity:
          Name:
            NameFull: Nederend, Joost
      – PersonEntity:
          Name:
            NameFull: Kusters, Miranda
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 11
              Text: Nov2021
              Type: published
              Y: 2021
          Identifiers:
            – Type: issn-print
              Value: 03603016
          Numbering:
            – Type: volume
              Value: 111
            – Type: issue
              Value: 3
          Titles:
            – TitleFull: International Journal of Radiation Oncology, Biology, Physics
              Type: main
ResultId 1