原发性直肠癌术前 MRI 对局部复发后手术的肿瘤学结局的预测价值。
Pretreatment MRI in Primary Rectal Cancer as a Predictor for Oncological Outcomes After Surgery for Local Recurrence.
机构信息
Department of Molecular Medicine and Surgery, Karolinska Institutet, Division of Coloproctology, Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden;
Department of Imaging and Physiology, Karolinska University Hospital, Stockholm, Sweden.
出版信息
Anticancer Res. 2021 May;41(5):2459-2465. doi: 10.21873/anticanres.15021.
BACKGROUND/AIM: For patients with locally recurrent rectal cancer (LRRC) extensive surgery is often the only curative option and patient selection is crucial. This study aimed to investigate whether magnetic resonance imaging (MRI) characteristics of the primary tumour can predict oncological outcome after surgery for locally recurrent rectal cancer (LRRC).
PATIENTS AND METHODS
All patients undergoing surgery for LRRC with a curative intent at the Karolinska University Hospital 2003-2013 were included. MRI examinations of the primary tumour were re-evaluated.
RESULTS
In total, 54 patients were included. A tumour volume decrease of <70% after preoperative radiotherapy or chemoradiotherapy (C)RT for the primary tumour was correlated with a lower proportion of R0 resection of the LRRC (OR=0.07, 95% CI=0.01-0.84). No association between MRI characteristics of the primary tumour and prognosis after LRRC surgery was found.
CONCLUSION
Long-term outcomes after surgery for LRRC were not significantly associated with MRI characteristics of the index tumour. However, factors associated with increased risk of R1 resection of LRRC were identified.
背景/目的：对于局部复发性直肠癌（LRRC）患者，广泛手术通常是唯一的治愈选择，因此患者选择至关重要。本研究旨在探讨原发性肿瘤的磁共振成像（MRI）特征是否可以预测局部复发性直肠癌（LRRC）手术后的肿瘤学结果。
患者和方法
纳入了 2003 年至 2013 年期间在卡罗林斯卡大学医院接受 LRRC 根治性手术的所有患者。对原发性肿瘤的 MRI 检查进行了重新评估。
结果
共纳入 54 例患者。原发性肿瘤在术前放疗或放化疗（C）RT 后体积减少<70%与 LRRC 的 R0 切除比例较低相关（OR=0.07，95%CI=0.01-0.84）。未发现原发性肿瘤的 MRI 特征与 LRRC 手术后的预后之间存在关联。
结论
LRRC 手术后的长期结果与指数肿瘤的 MRI 特征无显著相关性。但是，确定了与 LRRC 的 R1 切除风险增加相关的因素。
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