Combination of extramural venous invasion and lateral lymph node size detected with magnetic resonance imaging is a reliable biomarker for lateral lymph node metastasis in patients with rectal cancer

World Journal of Surgical Oncology

Hiroki Imamura¹  Masayuki Ohue¹  Takeshi Omori¹  Naotsugu Haraguchi¹  Nozomu Nakai¹  Masayoshi Yasui¹  Chu Matsuda¹  Hiroshi Wada¹  Hidenori Takahashi¹  Hiroshi Miyata¹  Junichi Nishimura¹  Tomoki Abe¹ 

[1] Department of Gastroenterological Surgery, Osaka International Cancer Institute, Otemae 3-1-69, Chuo-ku, 541-8567, Osaka City, Osaka, Japan;

关键词: Rectal cancer;    Lateral lymph node;    Lateral lymph node dissection;    Extramural venous invasion;    Magnetic resonance imaging;   

DOI  :  10.1186/s12957-021-02464-3

来源: Springer

【 摘 要 】

PurposePathological extramural venous invasion (EMVI) is defined as the active invasion of malignant cells into veins beyond the muscularis propria in colorectal cancer. It is associated with poor prognosis and increases the risk of disease recurrence. Specific findings on MRI (termed MRI-EMVI) are reportedly associated with pathological EMVI. In this study, we aimed to identify risk factors for lateral lymph node (LLN) metastasis related to rectal cancer and to evaluate whether MRI-EMVI could be a new and useful imaging biomarker to help LLN metastasis diagnosis besides LLN size.MethodsWe investigated 67 patients who underwent rectal resection and LLN dissection for rectal cancer. We evaluated MRI-EMVI grading score and examined the relationship between MRI-EMVI and LLN metastasis.ResultsPathological LLN metastasis was detected in 18 cases (26.9%), and MRI-EMVI was observed in 32 cases (47.8%). Patients were divided into two cohorts, according to LLN metastasis. Multivariate analyses demonstrated that higher risk of LLN metastasis was significantly associated with MRI-EMVI (P = 0.0112) and a short lateral lymph node axis (≥ 5 mm) (P = 0.0002). The positive likelihood ratios of MRI-EMVI alone, LLN size alone, and the combination of both factors were 2.12, 4.84, and 16.33, respectively. Patients negative for both showed better 2-year relapse-free survival compared to other patients (84.4% vs. 62.1%, P = 0.0374).ConclusionsMRI-EMVI was a useful imaging biomarker for identifying LLN metastasis in patients with rectal cancer. The combination of MRI-EMVI and LLN size can improve diagnostic accuracy.

【 授权许可】

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