Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India

Background Presence of extramural venous invasion (EMVI) is a poor prognostic factor for rectal cancer as per literature. However, India-specific data are lacking. Aim The aim of the study is to determine the prognostic significance of EMVI in locally advanced rectal cancer on baseline MR...

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Autores principales:	Sayali Y. Pangarkar, Akshay D. Baheti, Kunal A. Mistry, Amit J. Choudhari, Vasundhara R. Patil, Ankita Ahuja, Aparna N. Katdare, Akshay B. Patil, Vikas S. Ostwal, Mukta R. Ramadwar, Reena Z. Engineer, Avanish P. Saklani
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	extramural venous invasion mri rectal cancer Medical physics. Medical radiology. Nuclear medicine R895-920
Acceso en línea:	https://doaj.org/article/47b0e1d36ad34c56be46cfc2acdb4548
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spelling	oai:doaj.org-article:47b0e1d36ad34c56be46cfc2acdb45482021-11-13T23:32:30ZPrognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India0971-30261998-380810.1055/s-0041-1736404https://doaj.org/article/47b0e1d36ad34c56be46cfc2acdb45482021-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1736404https://doaj.org/toc/0971-3026https://doaj.org/toc/1998-3808Background Presence of extramural venous invasion (EMVI) is a poor prognostic factor for rectal cancer as per literature. However, India-specific data are lacking. Aim The aim of the study is to determine the prognostic significance of EMVI in locally advanced rectal cancer on baseline MRI. Materials and Methods We retrospectively reviewed 117 MRIs of operable non-metastatic locally advanced rectal cancers in a tertiary cancer institute. Three dedicated oncoradiologists determined presence or absence of EMVI, and its length and thickness, in consensus. These patients were treated as per standard institutional protocols and followed up for a median period of 37 months (range: 2–71 months). Kaplan-Meier curves (95% CI) were used to determine disease-free survival (DFS), distant-metastases free survival (DMFS), and overall survival (OS). Univariate analysis was performed by comparing groups with log-rank test. Results EMVI positive cases were 34/114 (29%). More EMVI-positive cases developed distant metastasis compared with EMVI-negative cases (14/34–41% vs. 22/83–26%). The difference, however, was not statistically significant (p = 0.146). After excluding signet-ring cell cancers (n = 14), EMVI showed significant correlation with DMFS (p = 0.046), but not with DFS or OS. The median thickness and length of EMVI was 6 and 14 mm, respectively in patients who developed distant metastasis, as compared with 5 and 11 mm in those who did not, although this difference was not statistically significant. Conclusion EMVI is a predictor of distant metastasis in locally advanced non-metastatic, non-signet ring cell rectal cancers. EMVI can be considered another high-risk feature to predict distant metastasis.Sayali Y. PangarkarAkshay D. BahetiKunal A. MistryAmit J. ChoudhariVasundhara R. PatilAnkita AhujaAparna N. KatdareAkshay B. PatilVikas S. OstwalMukta R. RamadwarReena Z. EngineerAvanish P. SaklaniThieme Medical and Scientific Publishers Pvt. Ltd.articleextramural venous invasionmrirectal cancerMedical physics. Medical radiology. Nuclear medicineR895-920ENIndian Journal of Radiology and Imaging, Vol 31, Iss 03, Pp 560-565 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	extramural venous invasion mri rectal cancer Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	extramural venous invasion mri rectal cancer Medical physics. Medical radiology. Nuclear medicine R895-920 Sayali Y. Pangarkar Akshay D. Baheti Kunal A. Mistry Amit J. Choudhari Vasundhara R. Patil Ankita Ahuja Aparna N. Katdare Akshay B. Patil Vikas S. Ostwal Mukta R. Ramadwar Reena Z. Engineer Avanish P. Saklani Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India
description	Background Presence of extramural venous invasion (EMVI) is a poor prognostic factor for rectal cancer as per literature. However, India-specific data are lacking. Aim The aim of the study is to determine the prognostic significance of EMVI in locally advanced rectal cancer on baseline MRI. Materials and Methods We retrospectively reviewed 117 MRIs of operable non-metastatic locally advanced rectal cancers in a tertiary cancer institute. Three dedicated oncoradiologists determined presence or absence of EMVI, and its length and thickness, in consensus. These patients were treated as per standard institutional protocols and followed up for a median period of 37 months (range: 2–71 months). Kaplan-Meier curves (95% CI) were used to determine disease-free survival (DFS), distant-metastases free survival (DMFS), and overall survival (OS). Univariate analysis was performed by comparing groups with log-rank test. Results EMVI positive cases were 34/114 (29%). More EMVI-positive cases developed distant metastasis compared with EMVI-negative cases (14/34–41% vs. 22/83–26%). The difference, however, was not statistically significant (p = 0.146). After excluding signet-ring cell cancers (n = 14), EMVI showed significant correlation with DMFS (p = 0.046), but not with DFS or OS. The median thickness and length of EMVI was 6 and 14 mm, respectively in patients who developed distant metastasis, as compared with 5 and 11 mm in those who did not, although this difference was not statistically significant. Conclusion EMVI is a predictor of distant metastasis in locally advanced non-metastatic, non-signet ring cell rectal cancers. EMVI can be considered another high-risk feature to predict distant metastasis.
format	article
author	Sayali Y. Pangarkar Akshay D. Baheti Kunal A. Mistry Amit J. Choudhari Vasundhara R. Patil Ankita Ahuja Aparna N. Katdare Akshay B. Patil Vikas S. Ostwal Mukta R. Ramadwar Reena Z. Engineer Avanish P. Saklani
author_facet	Sayali Y. Pangarkar Akshay D. Baheti Kunal A. Mistry Amit J. Choudhari Vasundhara R. Patil Ankita Ahuja Aparna N. Katdare Akshay B. Patil Vikas S. Ostwal Mukta R. Ramadwar Reena Z. Engineer Avanish P. Saklani
author_sort	Sayali Y. Pangarkar
title	Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India
title_short	Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India
title_full	Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India
title_fullStr	Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India
title_full_unstemmed	Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India
title_sort	prognostic significance of emvi in rectal cancer in a tertiary cancer hospital in india
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/47b0e1d36ad34c56be46cfc2acdb4548
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Prognostic Significance of EMVI in Rectal Cancer in a Tertiary Cancer Hospital in India

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