Article, 2024
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
European Journal of Surgical Oncology,
ISSN
0748-7983,
1532-2157,
Volume 50,
6,
Page 108307,
10.1016/j.ejso.2024.108307
Contributors
Van Geffen, Eline G M
[1]
[2]
Nederend, Joost
0000-0002-9905-5866
[3]
Sluckin, Tania C
0000-0002-5913-2644
[1]
[2]
Hazen, Sanne-Marije J A
0000-0001-8372-1986
[1]
[2]
Horsthuis, Karin
0000-0001-9699-4561
[1]
[2]
Beets-Tan, Regina Gien Hoa
[4]
[5]
[6]
[7]
Marijnen, Corrie A M
0000-0003-0189-5953
[7]
[8]
Tanis, Pieter Job
0000-0002-3146-3310
[1]
[2]
[9]
Kusters, Miranda
0000-0002-2468-9186
(Corresponding author)
[1]
[2]
Group, the Dutch Snapshot Research
[1]
[2]
[3]
[4]
[5]
[6]
[7]
[8]
[9]
Aalbers, Arend G.J.
Van Aalten, Susanna Maria
Amelung, Femke Julie
Ankersmit, Marjolein
Antonisse, Imogeen E
Ashruf, Jesse F
Aukema, Tjeerd S
Avenarius, Henk
Bahadoer, Renu R
0000-0002-6321-6453
Bakers, Frans C H
0000-0002-2327-4712
Bakker, Ilsalien S.
Bangert, Fleur
Barendse, Renée M.
Beekhuis, Heleen M D
Beets, Geerard L O
0000-0002-1671-9912
Bemelman, Willem Adrianus
Berbée, Maaike
De Bie, Shira H
Bisschops, Robert H C
Blok, Robin D.
Van Bockel, Liselotte W
Boer, Anniek H
Boer, Frank C Den
0000-0003-3754-1137
Boerma, Evert-Jan Gijsbert
0000-0001-6782-5670
Boogerd, Leonora S F
Borstlap, Jaap
Borstlap, Wernard Aat Antoine
Bouwman, Johanna E.
Braak, Sicco J
Braat, Manon N G J A
0000-0001-6580-4331
Bradshaw, Jennifer
Brandsma, Amarins T A
Van Breest Smallenburg, Vivian
Van Den Broek, Wim T
Van Der Burg, Sjirk W
Burger, Jacobus W.A.
Burghgraef, Thijs Adriaan
0000-0001-8781-9630
Cate, David W G Ten
0009-0003-3152-0797
Ceha, Heleen M
Cnossen, Jeltsje S
Van Den Braak, Robert R J Coebergh
0000-0001-9310-6629
Consten, Esther C J
Corver, Maaike
Crolla, Rogier M P H
0000-0003-2617-1791
Curutchet, Sam
Daniels-Gooszen, Alette W
Davids, Paul H P
Dekker, Emmelie N
Dekker, Jan Willem Teunis
0000-0003-2027-0027
Demirkiran, Ahmet
Derksen, Tyche
Diederik, Arjen L
Dinaux, Anne M
Dogan, Kemal
van Dop, Ilse M.
Greve, Kitty E Droogh-De
Duijsens, Hanneke M H
Dunker, Michalda S
Duyck, Johan
Van Duyn, Eino B
Van Egdom, Laurentine S E
0000-0003-2640-1948
Eijlers, Bram
El-Massoudi, Youssef
van Elderen, Saskia
Emmen, Anouk M L H
Engelbrecht, Marc
van Erp, Anne C.
Van Essen, Jeroen A
Fabry, Hans F J
Fassaert, Thomas
Feitsma, Eline A
0000-0001-8626-0863
Feshtali, Shirin Shahbazi
Frietman, Bas
0000-0002-3298-9330
Furnée, Edgar J B
van Geel, Anne M.
Geijsen, Elisabeth D
Van Geloven, Anna A W
Gerhards, Michael F.
Gielkens, Hugo
Van Gils, Renza A H
Goense, Lucas
Govaert, Marc J P M
Van Grevenstein, Wilhelmina M U
De Groof, Elisabeth J
de Groot, Irene
de Haas, Robbert J.
Hakkenbrak, Nadia A G
Hartogh, Mariska D Den
Heesink, Vera
Heikens, Joost T
0000-0002-0063-1705
Hendriksen, Ellen M.
Van Den Hoek, Sjoerd
Van Der Hoeven, Erik J R J
Hoff, Christiaan
Hogewoning, Anna
Hogewoning, Cornelis R C
0000-0003-4683-8741
Hoogendoorn, Stefan
van Hoorn, Francois
Van Der Hul, René L
Van Hulst, Rieke
Imani, Farshad
Inberg, Bas
Intven, Martijn P W
0000-0002-5068-5517
Janssen, Pedro
De Jong, Chris E J
Jonkers, Jacoline
Jou-Valencia, Daniela
Keizers, Bas
Ketelaers, Stijn H J
0000-0002-0756-5894
Knöps, Eva
Van Koeverden, Sebastiaan W
Kok, Sylvia
Kolderman, Stephanie E M
De Korte, Fleur I
Kortekaas, Robert Th J
Korving, Julie C.
Koster, Ingrid M.
Krdzalic, Jasenko
Krielen, Pepijn
0000-0002-1294-7053
Kroese, Leonard Frederik
0000-0002-4702-5227
Krul, Eveline J T
Lahuis, Derk H H
Lamme, Bas
Van Landeghem, An A G
Leijtens, Jeroen W A
0000-0002-0807-0471
Leseman-Hoogenboom, Mathilde M
De Lijster, Manou S
Marsman, Martijn S
Martens, MilouH.
Masselink, Ilse
van der Meij, Wout
Meijnen, Philip
Melenhorst, Jarno
De Mey, Dietrich J L
Moelker-Galuzina, Julia
Morsink, Linda
Mulder, Erik J.
Muller, Karin
Musters, Gijsbert Daniel
Neijenhuis, Peter A.
De Nes, Lindsey C F
0000-0001-7923-6312
Nielen, M.
van den Nieuwboer, Jan B.J.
Nieuwenhuis, Jonanne F
Nonner, Joost
Noordman, Bo Jan
Nordkamp, Stefi
0000-0002-9738-8691
Olthof, Pim B
0000-0002-1691-1808
Oosterling, Steven J.
Ootes, Daan
Oppedijk, Vera
Ott, Pieter
Paulusma, Ida
Peeters, Koen C M J
0000-0002-9332-1334
Pereboom, Ilona T A
Peringa, Jan
Pironet, Zoë
Plate, Joost D J
Polat, Fatih
Poodt, Ingrid G M
0000-0001-9137-7599
Posma, Lisanne A E
Prette, Jeroen F
Pultrum, Bareld B
Qaderi, Seyed M
van Rees, Jan M.
Renger, Rutger-Jan
Rombouts, Anouk J M
0000-0002-7272-3051
Roosen, Lodewijk J
Brinke, Ellen A Roskott-Ten
Rothbarth, Joost
Rouw, Dennis B
Rozema, Tom
Rütten, Heidi
Rutten, Harm J T
Van Der Sande, Marit E
Schaafsma, Boudewijn E
Schasfoort, Renske A
Scheurkogel, Merel M
Van Der Velden, Arjan P Schouten
Schreurs, Wilhelmina H.
Schuivens, Puck M.E.
Sietses, Colin
Simons, Petra C G
Slob, Marjan J
Slooter, Gerrit Dirk
Van Der Sluis, Martsje
Smalbroek, Bo P
0000-0002-8502-4890
Smits, Anke B
Spillenaar Bilgen, Ernst Jan
0000-0002-4125-9268
Spruit, Patty H
Stam, Tanja C
Stoker, Jaap
0000-0002-9822-3784
Talsma, Aaldert K
Temmink, Sofieke J D
Mireille The, G.Y.
Tielbeek, Jeroen A W
Van Tilborg, Aukje A J M
Van Tilborg, Fiek A J B
Van Trier, Dorothée
Tuynman, Jurriaan Benjamin
0000-0001-5952-8000
Van Der Valk, Maxime J M
Vanhooymissen, Inge J S M L
Vasbinder, G Boudewijn C
Veeken, Cornelis J
Velema, Laura A
Van De Ven, Anthony Willem Hendrik
Verdaasdonk, Emiel G G
0000-0002-2168-294X
Verduin, Wouter M
0000-0002-1039-2277
Verhagen, Tim
Verheijen, Paul M.
Vermaas, Maarten
Verrijssen, An-Sofie E
0000-0002-5193-2831
Verschuur, Anna Vera D
0000-0001-8085-1355
Schaik, Harmke Verwoerd-van
Vliegen, Roy F A
Voets, Sophie
Vogelaar, F Jeroen
Vogelij, Clementine L.A.
Vos-Westerman, Johanna
de Vries, Marianne
Vroemen, Joy C
Van Vugt, Bas S T
Wegdam, Johannes A
0000-0002-3287-0233
Van Wely, Bob J
Westerterp, Marinke
Van Westerveld, Paul P
Van Westreenen, Henderik Leendert
0000-0002-1910-2723
Wijma, Allard G
0000-0003-4227-4715
de Wilt, Johannes H.W.
De Wit, Bart Willem Karel
Wit, Fennie
Woensdregt, Karlijn
van Woerden, Victor
Van Der Wolf, Floor S W
van der Wolk, Sander
Wybenga, Johannes M
Van Der Zaag, Edwin S
Zamaray, Bobby
0000-0002-2361-7578
Zandvoort, Herman J A
van der Zee, Dennis
Zeilstra, Annette P
Zheng, Kang J.
Zimmerman, David D.E.
Zorgdrager, Marcel
Affiliations
- [1]
Amsterdam UMC Location VUmc
[NORA names:
Netherlands; Europe, EU; OECD];
- [2]
Amsterdam University Medical Centers
[NORA names:
Netherlands; Europe, EU; OECD];
- [3]
Catharina Ziekenhuis
[NORA names:
Netherlands; Europe, EU; OECD];
- [4]
Maastricht University
[NORA names:
Netherlands; Europe, EU; OECD];
- [5]
Odense University Hospital
[NORA names:
Region of Southern Denmark; Hospital; Denmark; Europe, EU; Nordic; OECD];
(... more)
- [6]
University of Southern Denmark
[NORA names:
SDU University of Southern Denmark;
University; Denmark; Europe, EU; Nordic; OECD];
- [7]
Antoni van Leeuwenhoek Hospital
[NORA names:
Netherlands; Europe, EU; OECD];
- [8]
Leiden University Medical Center
[NORA names:
Netherlands; Europe, EU; OECD];
- [9]
Erasmus MC
[NORA names:
Netherlands; Europe, EU; OECD]
(less)
Abstract
BACKGROUND: Detection 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.
METHODS: A 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).
RESULTS: The 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).
CONCLUSION: The 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.
Keywords
DM,
DM rates,
DM risk,
LR rate,
LR risk,
MRI scans,
MRI-detected extramural venous invasion,
abdominal radiologists,
absence,
advanced rectal cancer,
analysis,
anorectal junction,
associated in multivariate analysis,
cT3,
cancer,
cohort study,
cross-sectional study,
decreased DFS,
detection,
disappearance,
disease-free survival,
extramural venous invasion,
follow-up,
grade,
grade 3,
hospital,
images,
impact,
increased LR risk,
invasion,
junction,
local recurrence,
localization,
locally advanced rectal cancer,
magnetic resonance imaging,
median follow-up,
months,
mrEMVI,
multivariate analysis,
national cohort study,
negative oncological impact,
neo-adjuvant treatment,
neoadjuvant therapy,
overall survival,
patients,
prognostic significance,
radiologists,
radiology training,
rate,
reassessment,
rectal cancer,
rectal surgery,
recurrence,
resection,
resonance imaging,
response,
response to neo-adjuvant treatment,
restaging,
restaging magnetic resonance imaging,
retrospective cross-sectional study,
risk,
risk of DM,
stage,
study,
surgery,
survival,
survival rate,
therapy,
training,
treatment,
venous invasion
Funders
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