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European Radiology
Published in: European Radiology 2/2016

01-02-2016 | Oncology

Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI

Authors: Young Chul Kim, Jai Keun Kim, Myeong-Jin Kim, Jei Hee Lee, Young Bae Kim, Sung Jae Shin

Published in: European Radiology | Issue 2/2016

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Abstract

Objectives

To evaluate the feasibility of mesorectal vascular invasion (MVI) in predicting early distant metastasis developed within 1 year of diagnosis of T3 rectal cancer using magnetic resonance imaging (MRI)

Methods

Sixty-five patients with T3 rectal cancer (early metastasis, n = 28; non-metastasis, n = 37) were enrolled in this study. Early distant metastases developed in 28 patients (liver, n = 15; lung, n = 9; both, n = 4). Logistic regression was used to determine the independent predictors for early distant metastasis.

Results

In univariate analysis, tumour location, carcinoembryonic antigen (CEA), lymphovascular invasion (LVI), MRI-detected MVI, and mesorectal fat infiltration (MFI) (odds ratio [OR], 4.533, 9.583, 5.539, 27.046, and 5.539, respectively) were associated with early distant metastasis. Multivariate analysis demonstrated that MVI (OR, 29.949; P < 0.002) and LVI (OR, 6.684; P = 0.033) were independent factors for early distant metastasis. Specificity and positive predictive value (PPV) of MVI (94.59 %, and 89.47 %, respectively) were significantly higher than those of LVI (64.86 %, and 61.76 %), but sensitivity and negative predictive value were not significantly different between MVI (60.71 %, and 76.09 %) and LVI (75.00 %, and 77.42 %).

Conclusions

While sensitivity of MRI-detected MVI was equal to that of CEA in predicting early distant metastasis from T3 rectal cancer, specificity and PPV may be improved by assessing MVI.

Key points

• Mesorectal vascular invasion (MVI) may be a radiologic prognostic factor for rectal cancer.
• Specificity of MVI was higher than lymphovascular invasion in predicting early metastasis.
• Mesorectal vascular invasion may be a better predictor for early distant metastasis.
Literature
1.
Meguerditchian AN, Bairati I, Lagace R, Harel F, Kibrite A (2005) Prognostic significance of lymphovascular invasion in surgically cured rectal carcinoma. Am J Surg 189:707–713PubMedCrossRef
2.
Steup WH, Moriya Y, van de Velde CJ (2002) Patterns of lymphatic spread in rectal cancer. A topographical analysis on lymph node metastases. Eur J Cancer 38:911–918PubMedCrossRef
3.
Hong HS, Kim SH, Park HJ et al (2013) Correlations of dynamic contrast-enhanced magnetic resonance imaging with morphologic, angiogenic, and molecular prognostic factors in rectal cancer. Yonsei Med J 54:123–130PubMedPubMedCentralCrossRef
4.
Shihab OC, Moran BJ, Heald RJ, Quirke P, Brown G (2009) MRI staging of low rectal cancer. Eur Radiol 19:643–650PubMedCrossRef
5.
Nagtegaal ID, van de Velde CJ, Marijnen CA et al (2005) Low rectal cancer: a call for a change of approach in abdominoperineal resection. J Clin Oncol 23:9257–9264PubMedCrossRef
6.
Iizasa T, Suzuki M, Yoshida S et al (2006) Prediction of prognosis and surgical indications for pulmonary metastasectomy from colorectal cancer. Ann Thorac Surg 82:254–260PubMedCrossRef
7.
Huh JW, Kim CH, Lim SW, Kim HR, Kim YJ (2013) Early recurrence in patients undergoing curative surgery for colorectal cancer: is it a predictor for poor overall survival? Int J Colorectal Dis 28:1143–1149PubMedCrossRef
8.
Rosa Mendoza ES, Moreno E, Caguioa PB (2013) Predictors of early distant metastasis in women with breast cancer. J Cancer Res Clin Oncol 139:645–652PubMedCrossRef
9.
Zamarron C, Abdulkader I, Areses MC, Garcia-Paz V, Leon L, Cameselle-Teijeiro J (2013) Metastases of renal cell carcinoma to the thyroid gland with synchronous benign and malignant follicular cell-derived neoplasms. Case Rep Oncol Med. doi:10.​1155/​2013/​485025 PubMedPubMedCentral
10.
Hu H, Sun L, Guo C et al (2009) Tumor cell-microenvironment interaction models coupled with clinical validation reveal CCL2 and SNCG as two predictors of colorectal cancer hepatic metastasis. Clin Cancer Res 15:5485–5493PubMedCrossRef
11.
Kaur H, Choi H, You YN et al (2012) MR imaging for preoperative evaluation of primary rectal cancer: practical considerations. Radiographics 32:389–409PubMedCrossRef
12.
Shin R, Jeong SY, Yoo HY et al (2012) Depth of mesorectal extension has prognostic significance in patients with T3 rectal cancer. Dis Colon Rectum 55:1220–1228PubMedCrossRef
13.
Merkel S, Mansmann U, Siassi M, Papadopoulos T, Hohenberger W, Hermanek P (2001) The prognostic inhomogeneity in pT3 rectal carcinomas. Int J Colorectal Dis 16:298–304PubMedCrossRef
14.
MERCURY (2007) Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology 243:132–139CrossRef
15.
Beets-Tan RG (2003) MRI in rectal cancer: the T stage and circumferential resection margin. Colorectal Dis 5:392–395PubMedCrossRef
16.
Beets-Tan RG, Beets GL (2004) Rectal cancer: review with emphasis on MR imaging. Radiology 232:335–346PubMedCrossRef
17.
Brown G, Richards CJ, Newcombe RG et al (1999) Rectal carcinoma: thin-section MR imaging for staging in 28 patients. Radiology 211:215–222PubMedCrossRef
18.
Kim Y, Chung JJ, Yu JS, Cho ES, Kim JH (2013) Preoperative evaluation of lymphovascular invasion using high-resolution pelvic magnetic resonance in patients with rectal cancer: a 2-year follow-up study. J Comput Assist Tomogr 37:583–588PubMedCrossRef
19.
Sohn B, Lim JS, Kim H et al (2014) MRI-detected extramural vascular invasion is an independent prognostic factor for synchronous metastasis in patients with rectal cancer. Eur Radiol. doi:10.​1007/​s00330-014-3527-9
20.
Smith NJ, Barbachano Y, Norman AR, Swift RI, Abulafi AM, Brown G (2008) Prognostic significance of magnetic resonance imaging-detected extramural vascular invasion in rectal cancer. Br J Surg 95:229–236PubMedCrossRef
21.
Taylor FG, Swift RI, Blomqvist L, Brown G (2008) A systematic approach to the interpretation of preoperative staging MRI for rectal cancer. AJR Am J Roentgenol 191:1827–1835PubMedCrossRef
22.
Oh YT, Kim MJ, Lim JS et al (2005) Assessment of the prognostic factors for a local recurrence of rectal cancer: the utility of preoperative MR imaging. Korean J Radiol 6:8–16PubMedPubMedCentralCrossRef
23.
Beets-Tan RG, Lambregts DM, Maas M et al (2013) Magnetic resonance imaging for the clinical management of rectal cancer patients: recommendations from the 2012 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol 23:2522–2531PubMedCrossRef
24.
Ma CJ, Hsieh JS, Wang WM et al (2006) Multivariate analysis of prognostic determinants for colorectal cancer patients with high preoperative serum CEA levels: prognostic value of postoperative serum CEA levels. Kaohsiung J Med Sci 22:604–609PubMedCrossRef
25.
Wang L, Zhong XG, Peng YF, Li ZW, Gu J (2014) Prognostic value of pretreatment level of carcinoembryonic antigen on tumour downstaging and early occurring metastasis in locally advanced rectal cancer following neoadjuvant radiotherapy (30 Gy in 10 fractions). Colorectal Dis 16:33–39PubMedCrossRef
26.
Rao US, Hoerster NS, Thirumala S, Rao PS (2013) The influence of metastatic site on the expression of CEA and cellular localization of beta-catenin in colorectal cancer. J Gastroenterol Hepatol 28:505–512PubMedCrossRef
27.
28.
Kapiteijn E, Marijnen CA, Nagtegaal ID et al (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646PubMedCrossRef
29.
Arredondo J, Baixauli J, Beorlegui C et al (2013) Prognosis factors for recurrence in patients with locally advanced rectal cancer preoperatively treated with chemoradiotherapy and adjuvant chemotherapy. Dis Colon Rectum 56:416–421PubMedCrossRef
30.
Syk E, Glimelius B, Nilsson PJ (2010) Factors influencing local failure in rectal cancer: analysis of 2315 patients from a population-based series. Dis Colon Rectum 53:744–752PubMedCrossRef
31.
Yeo SG, Kim MJ, Kim DY et al (2013) Patterns of failure in patients with locally advanced rectal cancer receiving pre-operative or post-operative chemoradiotherapy. Radiat Oncol 8:114PubMedPubMedCentralCrossRef
32.
Talbot IC, Ritchie S, Leighton MH, Hughes AO, Bussey HJ, Morson BC (1980) The clinical significance of invasion of veins by rectal cancer. Br J Surg 67:439–442PubMedCrossRef
33.
Talbot IC, Ritchie S, Leighton MH, Hughes AO, Bussey HJ, Morson BC (1981) Spread of rectal cancer within veins. Histologic features and clinical significance. Am J Surg 141:15–17PubMedCrossRef
34.
Engstrom PF, Arnoletti JP, Benson AB 3rd et al (2009) NCCN Clinical Practice Guidelines in Oncology: rectal cancer. J Natl Compr Canc Netw 7:838–881PubMed
35.
Kim JY, Kim NK, Sohn SK et al (2009) Prognostic value of postoperative CEA clearance in rectal cancer patients with high preoperative CEA levels. Ann Surg Oncol 16:2771–2778PubMedPubMedCentralCrossRef
36.
Kim MS, Kim NK, Park JH (2012) Intramural recurrence without mucosal lesions after an endoscopic mucosal resection for early colorectal cancer. Ann Coloproctol 29:126–129CrossRef
Metadata
Title
Feasibility of mesorectal vascular invasion in predicting early distant metastasis in patients with stage T3 rectal cancer based on rectal MRI
Authors
Young Chul Kim
Jai Keun Kim
Myeong-Jin Kim
Jei Hee Lee
Young Bae Kim
Sung Jae Shin
Publication date
01-02-2016
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 2/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-015-3837-6

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