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Published in: Surgery Today 7/2015

01-07-2015 | Original Article

Correlation of rectal tumor volumes with oncological outcomes for low rectal cancers: does tumor size matter?

Authors: Muhammad Tayyab, Abdul Razack, Abhiram Sharma, James Gunn, John E. Hartley

Published in: Surgery Today | Issue 7/2015

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Abstract

Purposes

Several reports have described a relationship between tumor volume and oncological outcomes for certain cancers. There is paucity of similar data for rectal cancer. We conducted this study to establish whether tumor volume, mesorectal volume, and the tumor volume to mesorectal volume ratio (TV/MRV), evaluated by magnetic resonance imaging (MRI), affect the oncological outcomes of patients with rectal cancer.

Methods

We performed volumetric analysis of rectal tumors from magnetic resonance imaging (MRI) images and assessed their correlation with oncological outcomes, using clinical and radiological databases.

Results

The subjects of this study were 25 of 35 patients who underwent rectal cancer surgery after staging with MRI, after the exclusion of 7 patients for whom MRI images could not be retrieved and 3 patients who had metastases identified at diagnosis. Tumor volume (TV) was a significant predictor of overall survival hazard ratio (95 % CI); 5.8 (1.2–29), (P = 0.03). Mesorectal volume (MRV) and TV/MRV did not correlate with oncological outcomes.

Conclusions

We found a direct relationship between tumor volume and overall survival, which may be used to stratify rectal tumors for neoadjuvant therapy. A larger prospective study is required to confirm this correlation.
Literature
1.
go back to reference Alexander BM, Othus M, Caglar HB, Allen AM. Tumor volume is a prognostic factor in non-small-cell lung cancer treated with chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2011;79(5):1381–7.PubMedCrossRef Alexander BM, Othus M, Caglar HB, Allen AM. Tumor volume is a prognostic factor in non-small-cell lung cancer treated with chemoradiotherapy. Int J Radiat Oncol Biol Phys. 2011;79(5):1381–7.PubMedCrossRef
2.
go back to reference Pamir MN, Belirgen M, Ozduman K, Kilic T, Ozek M. Anterior clinoidal meningiomas: analysis of 43 consecutive surgically treated cases. Acta Neurochir (Wien). 2008;150(7):625–35.CrossRef Pamir MN, Belirgen M, Ozduman K, Kilic T, Ozek M. Anterior clinoidal meningiomas: analysis of 43 consecutive surgically treated cases. Acta Neurochir (Wien). 2008;150(7):625–35.CrossRef
3.
go back to reference Lee CC, Chu ST, Ho HC, Hung SK. Primary tumor volume calculation as a predictive factor of prognosis in nasopharyngeal carcinoma. Acta Otolaryngol. 2008;128(1):93–7.PubMedCrossRef Lee CC, Chu ST, Ho HC, Hung SK. Primary tumor volume calculation as a predictive factor of prognosis in nasopharyngeal carcinoma. Acta Otolaryngol. 2008;128(1):93–7.PubMedCrossRef
4.
go back to reference Chen MK, Lee HS, Chang CC. Primary tumour volume: important predictor of outcome for T3- and T4-staged nasopharyngeal carcinoma. J Otolaryngol. 2004;33(4):254–7.PubMedCrossRef Chen MK, Lee HS, Chang CC. Primary tumour volume: important predictor of outcome for T3- and T4-staged nasopharyngeal carcinoma. J Otolaryngol. 2004;33(4):254–7.PubMedCrossRef
5.
go back to reference Crispen PL, Boorjian SA, Lohse CM, Sebo TS, Cheville JC, Blute ML, et al. Outcomes following partial nephrectomy by tumor size. J Urol. 2008;180(5):1912–7.PubMedCrossRef Crispen PL, Boorjian SA, Lohse CM, Sebo TS, Cheville JC, Blute ML, et al. Outcomes following partial nephrectomy by tumor size. J Urol. 2008;180(5):1912–7.PubMedCrossRef
6.
go back to reference Kim SJ, Lee KK, Kim DG. Tumor size predicts the biological behavior and influence of operative modalities in hepatocellular carcinoma. Hepatogastroenterology. 2010;57(97):121–6.PubMed Kim SJ, Lee KK, Kim DG. Tumor size predicts the biological behavior and influence of operative modalities in hepatocellular carcinoma. Hepatogastroenterology. 2010;57(97):121–6.PubMed
7.
go back to reference Scott KW, Grace RH. The relationship between tumour volume and the extent of spread in colorectal carcinoma. Int J Colorectal Dis. 1994;9(4):203–6.PubMedCrossRef Scott KW, Grace RH. The relationship between tumour volume and the extent of spread in colorectal carcinoma. Int J Colorectal Dis. 1994;9(4):203–6.PubMedCrossRef
8.
go back to reference Torkzad MR, Blomqvist L. The mesorectum: morphometric assessment with magnetic resonance imaging. Eur Radiol. 2005;15(6):1184–91.PubMedCrossRef Torkzad MR, Blomqvist L. The mesorectum: morphometric assessment with magnetic resonance imaging. Eur Radiol. 2005;15(6):1184–91.PubMedCrossRef
9.
go back to reference Kim YH, Kim DY, Kim TH. Usefulness of magnetic resonance volumetric evaluation in predicting response to preoperative concurrent chemoradiotherapy in patients with resectable rectal cancer. Int J Radiat Oncol Biol Phys. 2005;62(3):761–8.PubMedCrossRef Kim YH, Kim DY, Kim TH. Usefulness of magnetic resonance volumetric evaluation in predicting response to preoperative concurrent chemoradiotherapy in patients with resectable rectal cancer. Int J Radiat Oncol Biol Phys. 2005;62(3):761–8.PubMedCrossRef
10.
go back to reference Quirke P, Durdey P, Dixon MF, Williams NS. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet. 1986;2(8514):996–9.PubMedCrossRef Quirke P, Durdey P, Dixon MF, Williams NS. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet. 1986;2(8514):996–9.PubMedCrossRef
11.
go back to reference Adam IJ, Mohamdee MO, Martin IG, Finan PJ, Johnston D, Mohamdee MO, et al. Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet. 1994;344(8924):707–11.PubMedCrossRef Adam IJ, Mohamdee MO, Martin IG, Finan PJ, Johnston D, Mohamdee MO, et al. Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet. 1994;344(8924):707–11.PubMedCrossRef
12.
go back to reference Ng IO, Luk IS, Yuen ST, Lau PWK, Pritchett CJ, Ng M, et al. Surgical lateral clearance in resected rectal carcinomas. A multivariate analysis of clinicopathologic features. Cancer. 1993;71(6):1972–6.PubMedCrossRef Ng IO, Luk IS, Yuen ST, Lau PWK, Pritchett CJ, Ng M, et al. Surgical lateral clearance in resected rectal carcinomas. A multivariate analysis of clinicopathologic features. Cancer. 1993;71(6):1972–6.PubMedCrossRef
13.
go back to reference de Haas-Kock DF, Baeten CG, Jager JJ, Langendijk JA, Schouten LJ, Volovics A, et al. Prognostic significance of radial margins of clearance in rectal cancer. Br J Surg. 1996;83(6):781–5.PubMedCrossRef de Haas-Kock DF, Baeten CG, Jager JJ, Langendijk JA, Schouten LJ, Volovics A, et al. Prognostic significance of radial margins of clearance in rectal cancer. Br J Surg. 1996;83(6):781–5.PubMedCrossRef
14.
go back to reference Birbeck KF, Macklin CP, Tiffin NJ, Parsons W, Dixon MF, Mapstone NP, et al. Rates of circumferential resection margin involvement vary between surgeons and predict outcomes in rectal cancer surgery. Ann Surg. 2002;235(4):449–57.PubMedCentralPubMedCrossRef Birbeck KF, Macklin CP, Tiffin NJ, Parsons W, Dixon MF, Mapstone NP, et al. Rates of circumferential resection margin involvement vary between surgeons and predict outcomes in rectal cancer surgery. Ann Surg. 2002;235(4):449–57.PubMedCentralPubMedCrossRef
15.
go back to reference Nagtegaal ID, Marijnen CA, Kranenbarg EK, van de Velde CJ, van Krieken JH. Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma: not one millimeter but two millimeters is the limit. Am J Surg Pathol. 2002;26(3):350–7.PubMedCrossRef Nagtegaal ID, Marijnen CA, Kranenbarg EK, van de Velde CJ, van Krieken JH. Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma: not one millimeter but two millimeters is the limit. Am J Surg Pathol. 2002;26(3):350–7.PubMedCrossRef
16.
go back to reference Bokey EL, Chapuis PH, Dent OF, Newland RC, Koorey SG, Zelas PJ, et al. Factors affecting survival after excision of the rectum for cancer: a multivariate analysis. Dis Colon Rectum. 1997;40(1):3–10.PubMedCrossRef Bokey EL, Chapuis PH, Dent OF, Newland RC, Koorey SG, Zelas PJ, et al. Factors affecting survival after excision of the rectum for cancer: a multivariate analysis. Dis Colon Rectum. 1997;40(1):3–10.PubMedCrossRef
17.
go back to reference Horn A, Dahl O, Morild I. Venous and neural invasion as predictors of recurrence in rectal adenocarcinoma. Dis Colon Rectum. 1991;34(9):798–804.PubMedCrossRef Horn A, Dahl O, Morild I. Venous and neural invasion as predictors of recurrence in rectal adenocarcinoma. Dis Colon Rectum. 1991;34(9):798–804.PubMedCrossRef
18.
go back to reference Harrison JC, Dean PJ, el-Zeky F, Vander Zwaag R. From Dukes through Jass: pathological prognostic indicators in rectal cancer. Hum Pathol. 1994;25(5):498–505.PubMedCrossRef Harrison JC, Dean PJ, el-Zeky F, Vander Zwaag R. From Dukes through Jass: pathological prognostic indicators in rectal cancer. Hum Pathol. 1994;25(5):498–505.PubMedCrossRef
19.
go back to reference Mathis KL, Larson DW, Dozois EJ, Cima RR, Huebner M, Haddock MG, et al. Outcomes following surgery without radiotherapy for rectal cancer. Br J Surg. 2012;99(1):137–43.PubMedCrossRef Mathis KL, Larson DW, Dozois EJ, Cima RR, Huebner M, Haddock MG, et al. Outcomes following surgery without radiotherapy for rectal cancer. Br J Surg. 2012;99(1):137–43.PubMedCrossRef
20.
go back to reference Kim YJ, Park SC, Kim DY, Moon SH, Chang HJ, Park JW, et al. No correlation between pretreatment serum CEA levels and tumor volume in locally advanced rectal cancer patients. Clin Chim Acta. 2012;413(3–4):511–5.PubMedCrossRef Kim YJ, Park SC, Kim DY, Moon SH, Chang HJ, Park JW, et al. No correlation between pretreatment serum CEA levels and tumor volume in locally advanced rectal cancer patients. Clin Chim Acta. 2012;413(3–4):511–5.PubMedCrossRef
21.
go back to reference Poritz LS, Sehgal R, Hartnett K, Berg A, Koltun WA. Tumor volume and percent positive lymph nodes as a predictor of 5-year survival in colorectal cancer. Surgery. 2011;150(4):649–55.PubMedCrossRef Poritz LS, Sehgal R, Hartnett K, Berg A, Koltun WA. Tumor volume and percent positive lymph nodes as a predictor of 5-year survival in colorectal cancer. Surgery. 2011;150(4):649–55.PubMedCrossRef
22.
go back to reference Torkzad MR, Hansson KA, Lindholm J, Martling A, Blomqvist L. Significance of mesorectal volume in staging of rectal cancer with magnetic resonance imaging and the assessment of involvement of the mesorectal fascia. Eur Radiol. 2007;17(7):1694–9.PubMedCrossRef Torkzad MR, Hansson KA, Lindholm J, Martling A, Blomqvist L. Significance of mesorectal volume in staging of rectal cancer with magnetic resonance imaging and the assessment of involvement of the mesorectal fascia. Eur Radiol. 2007;17(7):1694–9.PubMedCrossRef
23.
go back to reference Gwynne S, Mukherjee S, Webster R, Spezi E, Staffurth J, Coles B, et al. Imaging for target volume delineation in rectal cancer radiotherapy–a systematic review. Clin Oncol (R Coll Radiol). 2012;24(1):52–63.CrossRef Gwynne S, Mukherjee S, Webster R, Spezi E, Staffurth J, Coles B, et al. Imaging for target volume delineation in rectal cancer radiotherapy–a systematic review. Clin Oncol (R Coll Radiol). 2012;24(1):52–63.CrossRef
24.
go back to reference Marincas M, Cirimbei C, Prunoiu V, Eliescu AL, Buzatu R, Stefan I, et al. Postradiotherapy regression–a prognostic factor in rectal neoplasm. Chirurgia (Bucur). 2011;106(6):753–8. Marincas M, Cirimbei C, Prunoiu V, Eliescu AL, Buzatu R, Stefan I, et al. Postradiotherapy regression–a prognostic factor in rectal neoplasm. Chirurgia (Bucur). 2011;106(6):753–8.
25.
go back to reference Nougaret S, Rouanet P, Molinari N, Pierredon MA, Bibeau F, Azria D, et al. MR volumetric measurement of low rectal cancer helps predict tumor response and outcome after combined chemotherapy and radiation therapy. Radiology. 2012;263(2):409–18.PubMedCrossRef Nougaret S, Rouanet P, Molinari N, Pierredon MA, Bibeau F, Azria D, et al. MR volumetric measurement of low rectal cancer helps predict tumor response and outcome after combined chemotherapy and radiation therapy. Radiology. 2012;263(2):409–18.PubMedCrossRef
26.
go back to reference Yeo SG, Kim DY, Park JW, Oh JH, Kim SY, Chang HJ, et al. Tumor volume reduction rate after preoperative chemoradiotherapy as a prognostic factor in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. 2012;82(2):e193–9.PubMedCrossRef Yeo SG, Kim DY, Park JW, Oh JH, Kim SY, Chang HJ, et al. Tumor volume reduction rate after preoperative chemoradiotherapy as a prognostic factor in locally advanced rectal cancer. Int J Radiat Oncol Biol Phys. 2012;82(2):e193–9.PubMedCrossRef
Metadata
Title
Correlation of rectal tumor volumes with oncological outcomes for low rectal cancers: does tumor size matter?
Authors
Muhammad Tayyab
Abdul Razack
Abhiram Sharma
James Gunn
John E. Hartley
Publication date
01-07-2015
Publisher
Springer Japan
Published in
Surgery Today / Issue 7/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-014-1068-0

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