Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer.
BACKGROUND
Extramural vascular invasion (EMVI) is a poor prognostic feature in colorectal cancer. The accuracy of magnetic resonance imaging (MRI) in detecting EMVI and predicting relapse-free survival (RFS) was compared retrospectively with the histological reference standard.


METHODS
Preoperative magnetic resonance images from patients diagnosed with rectal and sigmoid cancer were reviewed and an MRI-EMVI score (range 0 to 4) was assigned. Comparison was made with histology and clinical outcome.


RESULTS
Some 142 patients with a median follow-up of 3.3 (range 0.9-5.7) years were reviewed. Histological EMVI was reported in a quarter of patients. The sensitivity and specificity of MRI detection of EMVI in 94 patients undergoing primary surgery were 62 and 88 per cent respectively. On univariable analysis, RFS at 3 years was 35 per cent for patients with an MRI-EMVI score of 3-4, compared with 74 per cent for those with a score of 0-2 (P < 0.001), similar to values in patients with positive and negative histological EMVI status respectively (34 versus 73.7 per cent; P < 0.001).


CONCLUSIONS
High MRI-EMVI scores may help in predicting disease relapse.
Smith
N J
NJ
Department of Colorectal Surgery, Mayday University Hospital, Croydon, UK.
Barbachano
Y
Y
Norman
A R
AR
Swift
R I
RI
Abulafi
A M
AM
Brown
G
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery