Circumferential resection margin positivity after preoperative chemoradiotherapy based on magnetic resonance imaging for locally advanced rectal cancer: implication of boost radiotherapy to the involved mesorectal fascia

Japanese Journal of Clinical Oncology
Kyung Hwan KimWoong Sub Koom

Abstract

To identify patients who are at a higher risk of pathologic circumferential resection margin involvement using preoperative magnetic resonance imaging. Between October 2008 and November 2012, 165 patients with locally advanced rectal cancer (cT4 or cT3 with <2 mm distance from tumour to mesorectal fascia) who received preoperative chemoradiotherapy were analysed. The morphologic patterns on post-chemoradiotherapy magnetic resonance imaging were categorized into five patterns from Pattern A (most-likely negative pathologic circumferential resection margin) to Pattern E (most-likely positive pathologic circumferential resection margin). In addition, the location of mesorectal fascia involvement was classified as lateral, posterior and anterior. The diagnostic accuracy of the morphologic criteria was calculated using receiver operating characteristic curve analysis. Pathologic circumferential resection margin involvement was identified in 17 patients (10.3%). The diagnostic accuracy of predicting pathologic circumferential resection margin involvement was 0.73 using the five-scale magnetic resonance imaging pattern. The sensitivity, specificity, positive predictive value and negative predictive value for predicting pathologic circ...Continue Reading

References

Oct 22, 2004·The New England Journal of Medicine·Rolf SauerUNKNOWN German Rectal Cancer Study Group
Jan 10, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Iris D Nagtegaal, Phil Quirke
Mar 10, 2010·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Sang Joon ShinJoong Bae Ahn
Mar 20, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·E García-GraneroA Cervantes
Aug 31, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Uday B PatelGina Brown
Apr 25, 2012·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Rolf SauerClaus Rödel

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Citations

Jul 5, 2019·Korean Journal of Radiology : Official Journal of the Korean Radiological Society·Nieun SeoJoon Seok Lim
Sep 8, 2021·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Cecilia DahlbäckPamela Buchwald

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