文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

治疗后MRI特征能否预测低位直肠肿瘤的病理环周切缘(pCRM)受累情况?

Can Post-Treatment MRI Features Predict Pathological Circumferential Resection Margin (pCRM) Involvement in Low Rectal Tumors.

作者信息

Patra A, Baheti A D, Ankathi S K, Desouza A, Engineer R, Ostwal V, Ramaswamy A, Saklani A

机构信息

Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India.

Department of Radiodiagnosis, Homi Bhabha National Institute, Mumbai, India.

出版信息

Indian J Surg Oncol. 2020 Dec;11(4):720-725. doi: 10.1007/s13193-020-01218-z. Epub 2020 Sep 22.


DOI:10.1007/s13193-020-01218-z
PMID:33281411
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7714814/
Abstract

The MERCURY II study demonstrated the use of MRI-based risk factors such as extramural venous invasion (EMVI), tumor location, and circumferential resection margin (CRM) involvement to preoperatively predict pCRM (pathological CRM) outcomes for lower rectal tumors in a mixed group of upfront operated patients and patients who received neoadjuvant treatment. We aim to study the applicability of results of MERCURY II study in a homogeneous cohort of patients who received neoadjuvant chemoradiation (NACTRT) prior to surgery. After Institutional Review Board approval, post NACTRT restaging MRI of 132 patients operated for low rectal cancer between 2014 and 2018 were retrospectively reviewed by two radiologists for site of tumor, EMVI status, distance from anal verge (< 4 or > 4 cm), and mrCRM positivity. Findings were compared with post surgery pCRM outcomes using Fisher's exact test. Only 9/132(7%) patients showed pCRM involvement on histopathology, 8 of them being CRM positive on MRI ( = 0.01). The positive predictive value (PPV) of mrCRM positive status and pCRM status was 12.7% (95% CI: 9.7-16.5%), while the negative predictive value was 98.5% (95% CI: 91.4-99.8%) ( = 0.01). EMVI positive and anteriorly located tumors showed higher incidence of pCRM positivity but were not found to be significant (15% vs 5.2% and  = 0.13 and 8.6% vs 2.1% and  = 0.28, respectively). Unsafe mrCRM was the only factor significantly associated with pCRM positivity on post neoadjuvant restaging MRI. Tumors less than 4 cm from anal verge, anterior tumor location, and mrEMVI positivity did not show statistically significant results to predict pCRM involvement.

摘要

MERCURY II研究表明,在一组接受 upfront 手术的患者和接受新辅助治疗的患者中,基于MRI的危险因素,如壁外静脉侵犯(EMVI)、肿瘤位置和环周切缘(CRM)受累情况,可用于术前预测低位直肠肿瘤的pCRM(病理CRM)结果。我们旨在研究MERCURY II研究结果在一组术前接受新辅助放化疗(NACTRT)的同质患者中的适用性。经机构审查委员会批准,对2014年至2018年间接受低位直肠癌手术的132例患者的NACTRT后分期MRI进行回顾性分析,由两名放射科医生评估肿瘤部位、EMVI状态、距肛缘距离(<4或>4 cm)和mrCRM阳性情况。使用Fisher精确检验将结果与术后pCRM结果进行比较。仅9/132(7%)例患者在组织病理学上显示pCRM受累,其中8例MRI上CRM阳性(P = 0.01)。mrCRM阳性状态与pCRM状态的阳性预测值(PPV)为12.7%(95%CI:9.7 - 16.5%),而阴性预测值为98.5%(95%CI:91.4 - 99.8%)(P = 0.01)。EMVI阳性和位于前方的肿瘤显示pCRM阳性的发生率较高,但差异无统计学意义(分别为15%对5.2%,P = 0.13;8.6%对2.1%,P = 0.28)。不安全的mrCRM是新辅助分期MRI上与pCRM阳性显著相关的唯一因素。距肛缘小于4 cm的肿瘤、前方肿瘤位置和mrEMVI阳性在预测pCRM受累方面未显示出统计学显著结果。

相似文献

[1]
Can Post-Treatment MRI Features Predict Pathological Circumferential Resection Margin (pCRM) Involvement in Low Rectal Tumors.

Indian J Surg Oncol. 2020-12

[2]
Prospective Validation of a Low Rectal Cancer Magnetic Resonance Imaging Staging System and Development of a Local Recurrence Risk Stratification Model: The MERCURY II Study.

Ann Surg. 2016-4

[3]
Preoperative MRI accuracy after neoadjuvant chemoradiation for locally advanced rectal cancer.

Med Pharm Rep. 2023-7

[4]
Characteristics and Prognostic Significance of Preoperative Magnetic Resonance Imaging-Assessed Circumferential Margin in Rectal Cancer.

Gastroenterol Res Pract. 2015

[5]
Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy.

Medicina (Kaunas). 2024-2-15

[6]
Clinical Outcomes of Patients With Locally Advanced Rectal Cancer With Persistent Circumferential Resection Margin Invasion After Preoperative Chemoradiotherapy.

Ann Coloproctol. 2019-4

[7]
Predicting Positive Radial Margin on Restaging MRI of Patients with Low Rectal Cancer: Can We Do Better?

Indian J Radiol Imaging. 2023-9-16

[8]
Multimodal Treatment of cT3 Rectal Cancer in a Prospective Multi-Center Observational Study: Can Neoadjuvant Chemoradiation Be Omitted in Patients with an MRI-Assessed, Negative Circumferential Resection Margin?

Visc Med. 2021-10

[9]
Magnetic resonance imaging performed before and after preoperative chemoradiotherapy in rectal cancer: predictive factors of recurrence and prognostic significance of MR-detected extramural venous invasion.

Abdom Radiol (NY). 2020-10

[10]
MRI-based indications for neoadjuvant radiochemotherapy in rectal carcinoma: interim results of a prospective multicenter observational study.

Ann Surg Oncol. 2011-4-21

引用本文的文献

[1]
Abdominoperineal Resection for T4 Low Rectal Cancer After Neoadjuvant Therapy-Are the Outcomes Acceptable?

Indian J Surg Oncol. 2024-12

[2]
Imaging and Metabolic Diagnostic Methods in the Stage Assessment of Rectal Cancer.

Cancers (Basel). 2024-7-16

[3]
Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy.

Medicina (Kaunas). 2024-2-15

[4]
Predicting Positive Radial Margin on Restaging MRI of Patients with Low Rectal Cancer: Can We Do Better?

Indian J Radiol Imaging. 2023-9-16

[5]
Clinical Robotic Surgery Association (India Chapter) and Indian rectal cancer expert group's practical consensus statements for surgical management of localized and locally advanced rectal cancer.

Front Oncol. 2022-10-4

本文引用的文献

[1]
Can CRM Status on MRI Predict Survival in Rectal Cancers: Experience from the Indian Subcontinent.

Indian J Surg Oncol. 2019-6

[2]
Is the accuracy of preoperative MRI stage in rectal adenocarcinoma influenced by tumour height?

Acta Oncol. 2018-1-31

[3]
Colorectal Cancer in India: An Audit from a Tertiary Center in a Low Prevalence Area.

Indian J Surg Oncol. 2017-12

[4]
The Impact of Tumour Distance From the Anal Verge on Clinical Management and Outcomes in Patients Having a Curative Resection for Rectal Cancer.

J Gastrointest Surg. 2017-9-18

[5]
Does circumferential tumor location affect the circumferential resection margin status in mid and low rectal cancer?

Asian J Surg. 2017-1-21

[6]
Re-Staging Following Long-Course Chemoradiotherapy For Rectal Cancer: Does It Influence Management?

Ulster Med J. 2016-9

[7]
Surgery for Locally Advanced T4 Rectal Cancer: Strategies and Techniques.

Clin Colon Rectal Surg. 2016-6

[8]
Predictors of circumferential resection margin involvement in surgically resected rectal cancer: A retrospective review of 23,464 patients in the US National Cancer Database.

Int J Surg. 2016-4

[9]
Long-course oxaliplatin-based preoperative chemoradiation versus 5 × 5 Gy and consolidation chemotherapy for cT4 or fixed cT3 rectal cancer: results of a randomized phase III study.

Ann Oncol. 2016-2-15

[10]
Systematic review of prognostic importance of extramural venous invasion in rectal cancer.

World J Gastroenterol. 2016-1-28

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索