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Prognostic significance of MRI-detected extramural venous invasion according to grade and response to neo-adjuvant treatment in locally advanced rectal cancer A national cohort study after radiologic training and reassessment

2024; Elsevier BV; Volume: 50; Issue: 6 Linguagem: Inglês

10.1016/j.ejso.2024.108307

1532-2157

Eline G M van Geffen, Joost Nederend, Tania C. Sluckin, Sanne-Marije J.A. Hazen, Karin Horsthuis, Regina G. H. Beets‐Tan, Corrie A.M. Marijnen, Pieter J. Tanis, Miranda Kusters, Arend G. J. Aalbers, Susanna M. van Aalten, Femke J. Amelung, Marjolein Ankersmit, Imogeen E. Antonisse, J. F. Ashruf, Tjeerd S. Aukema, Henk Avenarius, Renu R. Bahadoer, Frans C. H. Bakers, Ilsalien S. Bakker, Fleur Bangert, Renée M. Barendse, Heleen M. D. Beekhuis, Geerard L. Beets, Willem A. Bemelman, Maaike Berbée, Shira H. de Bie, Robert H. C. Bisschops, Robin D. Blok, Liselotte W. van Bockel, Anniek H. Boer, Frank C. den Boer, Evert-Jan G. Boerma, Leonora S. F. Boogerd, Jaap Borstlap, Wernard A. A. Borstlap, Johanna E. Bouwman, Sicco J. Braak, Manon N.G.J.A. Braat, Jennifer Bradshaw, Amarins T. A. Brandsma, Vivian van Breest Smallenburg, W.T. van den Broek, Sjirk W. van der Burg, Jacobus W. A. Burger, Thijs A. Burghgraef, David W.G. ten Cate, Heleen M. Ceha, Jeltsje S. Cnossen, Robert R.J. Coebergh van den Braak, Esther C. J. Consten, Maaike Corver, Rogier M. P. H. Crolla, Sam Curutchet, Alette W. Daniëls-Gooszen, P. H. P. Davids, Emmelie N. Dekker, Jan Willem T. Dekker, Ahmet Demirkıran, Tyche Derksen, Arjen L. Diederik, Anne M. Dinaux, Kemal Doğan, Ilse M. van Dop, Kitty E. Droogh-de Greve, Hanneke M. H. Duijsens, Michalda S. Dunker, Johan Duyck, Eino B. van Duyn, Laurentine S. E. van Egdom, Bram Eijlers, Youssef El-Massoudi, Saskia van Elderen, Anouk M.L.H. Emmen, Marc R. Engelbrecht, Anne C. van Erp, Jeroen A. van Essen, Hans F. J. Fabry, Thomas Fassaert, Eline A. Feitsma, Shirin S. Feshtali, Bas Frietman, Edgar J.B. Furnée, Anne M. van Geel, Elisabeth D. Geijsen, Anna A. W. van Geloven, Michael F. Gerhards, H. A. J. Gielkens, Renza A. H. van Gils, Lucas Goense, Marc J. P. M. Govaert, Wilhelmina M. U. van Grevenstein, E. Joline de Groof, Irene de Groot, Robbert J. de Haas, Nadia A. G. Hakkenbrak, M.D. den Hartogh, Vera Heesink, Joost T. Heikens, Ellen M. Hendriksen, Sjoerd van den Hoek, E.J. Hoeven, Christiaan Hoff, Anna Hogewoning, Cornelis R. C. Hogewoning, Stefan Hoogendoorn, François van Hoorn, René L. van der Hul, Rieke van Hulst, Farshad Imani, Bas Inberg, Martijn Intven, Pedro Janssen, Chris E. J. de Jong, Jacoline Jonkers, Daniela Jou-Valencia, Bas Keizers, Stijn H. J. Ketelaers, Eva Knöps, Sebastiaan van Koeverden, Sylvia Kok, Stephanie E. M. Kolderman, Fleur I. de Korte, R.T.J. Kortekaas, Julie C. Korving, Ingrid Köster, Jasenko Krdzalic, Pepijn Krielen, Leonard F. Kroese, Eveline J. T. Krul, Derk H. H. Lahuis, Bas Lamme, An A. G. van Landeghem, Jeroen W. A. Leijtens, Mathilde M. Leseman-Hoogenboom, Manou S. de Lijster, Martijn S. Marsman, MilouH. Martens, Ilse Masselink, Wout van der Meij, Philip Meijnen, Jarno Melenhorst, Dietrich J. L. de Mey, Julia Moelker-Galuzina, Linda Morsink, Erik J. Mulder, Karin H. Müller, Gijsbert D. Musters, Peter A. Neijenhuis, Lindsey C. F. de Nes, M. Nielen, Jan B. J. van den Nieuwboer, Jonanne F. Nieuwenhuis, Joost Nonner, Bo Jan Noordman, Stefi Nordkamp, Pim B. Olthof, Steven J. Oosterling, Daan Ootes, Vera Oppedijk, Pieter Ott, Ida Paulusma, Koen Peeters, Ilona T. A. Pereboom, Jan Peringa, Zoë Pironet, Joost D. J. Plate, Fatih Polat, Ingrid G. M. Poodt, Lisanne A. E. Posma, Jeroen F. Prette, Bareld B. Pultrum, Seyed M. Qaderi, Jan M. van Rees, Rutger-Jan Renger, Anouk J. M. Rombouts, Lodewijk J. Roosen, Ellen A. Roskott-ten Brinke, Joost Rothbarth, Dennis B. Rouw, Tom Rozema, Heidi Rütten, H.J.T. Rutten, Marit E. van der Sande, Boudewijn E. Schaafsma, Renske A. Schasfoort, Merel M. Scheurkogel, Arjan P. Schouten van der Velden, Wilhelmina H. Schreurs, Puck M.E. Schuivens, Colin Sietses, Petra C. G. Simons, Marjan J. Slob, Gerrit D. Slooter, Martsje van der Sluis, Bo P. Smalbroek, Anke B. Smits, Ernst J. Spillenaar-Bilgen, Patty H. Spruit, Tanja C. Stam, Jaap Stoker, Aaldert K. Talsma, Sofieke Temmink, G. Y. Mireille The, Jeroen A. W. Tielbeek, Aukje A. J. M. van Tilborg, Fiek van Tilborg, Dorothée van Trier, Jurriaan B. Tuynman, Maxime J.M. van der Valk, Inge J. S. Vanhooymissen, G. Boudewijn C. Vasbinder, Cornelis J. Veeken, Laura A. Velema, Anthony W. H. van de Ven, Emiel G. G. Verdaasdonk, Wouter M. Verduin, Tim Verhagen, Paul M. Verheijen, Maarten Vermaas, An-Sofie Verrijssen, Anna V. D. Verschuur, Harmke Verwoerd-van Schaik, Roy F. A. Vliegen, Sophie Voets, F. Jeroen Vogelaar, Clementine L. A. Vogelij, Johanna Vos-Westerman, Marianne de Vries, Joy C. Vroemen, Bas S. T. van Vugt, Johannes A. Wegdam, Bob J. van Wely, Marinke Westerterp, Paul P. van Westerveld, Henderik L. van Westreenen, Allard G. Wijma, Johannes H.W. de Wilt, Bart W. K. de Wit, Fennie Wit, Karlijn Woensdregt, Victor van Woerden, Floor S. W. van der Wolf, Sander van der Wolk, Johannes M. Wybenga, Edwin S. van der Zaag, Bobby Zamaray, Herman J.A. Zandvoort, Dennis van der Zee, Annette P. Zeilstra, Kang J. Zheng, D. D. E. Zimmerman, Marcel Zorgdrager,

Colorectal Cancer Screening and Detection

BackgroundDetection of grade 3–4 extra mural venous invasion (mrEMVI) on magnetic resonance imaging (MRI) is associated with an increased distant metastases (DM)-rate. This study aimed to determine the impact of different grades of mrEMVI and their disappearance after neoadjuvant therapy.MethodsA Dutch national retrospective cross-sectional study was conducted, including patients who underwent resection for rectal cancer in 2016 from 60/69 hospitals performing rectal surgery. Patients with a cT3-4 tumour ≤8 cm from the anorectal junction were selected and their MRI-scans were reassessed by trained abdominal radiologists. Positive mrEMVI grades (3 and 4) were analyzed in regard to 4-year local recurrence (LR), DM, disease-free survival (DFS) and overall survival (OS).ResultsThe 1213 included patients had a median follow-up of 48 months (IQR 30–54). Positive mrEMVI was present in 324 patients (27%); 161 had grade 3 and 163 had grade 4. A higher mrEMVI stage (grade 4 vs grade 3 vs no mrEMVI) increased LR-risk (21% vs 18% vs 7%, <0.001) and DM-risk (49% vs 30% vs 21%, p < 0.001) and decreased DFS (42% vs 55% vs 69%, p < 0.001) and OS (62% vs 76% vs 81%, p < 0.001), which remained independently associated in multivariable analysis. When mrEMVI had disappeared on restaging MRI, DM-rate was comparable to initial absence of mrEMVI (both 26%), whereas LR-rate remained high (22% vs 9%, p = 0.006).ConclusionThe negative oncological impact of mrEMVI on recurrence and survival rates was dependent on grading. Disappearance of mrEMVI on restaging MRI decreased the risk of DM, but not of LR.