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

Authors
Kim, YC  | Kim, JK  | Kim, MJ | Lee, JH  | Kim, YB  | Shin, SJ
Citation
European radiology, 26(2). : 297-305, 2016
Journal Title
European radiology
ISSN
0938-79941432-1084
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.
MeSH

DOI
10.1007/s00330-015-3837-6
PMID
26017737
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Radiology
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Ajou Authors
김, 영배  |  김, 영철  |  김, 재근  |  신, 성재  |  이, 제희
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