Findings in magnetic resonance imaging for restaging locally advanced rectal cancer

Suvi Marjasuo, Laura Koskenvuo, Anna Lepistö

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Abstract

Purpose: We aimed to assess the prognostic value of restaging magnetic resonance imaging (MRI) in rectal cancer after neoadjuvant therapy and compare long-course chemoradiotherapy (LC-CRT) to short-course radiotherapy with delayed surgery (SCRT-delay). Methods: This retrospective study included 267 patients with locally advanced rectal cancer (LARC) operated on between January 2016 and April 2019, all of whom received either LC-CRT or SCRT-delay in the neoadjuvant setting. The primary outcomes were overall survival (OS) and cancer-specific survival (CSS) based on radiological response assessed using the magnetic resonance tumor regression grade (mrTRG). Results: In the LC-CRT group, cumulative 1-, 3-, and 5-year OS rates were 94.8%, 86.4%, and 79.0%, while in the SCRT-delay group, they were 83.3%, 68.9%, and 68.9% (P = 0.017). For CSS in the LC-CRT group, cumulative rates were 96.9%, 90.3%, and 85.0%, and in the SCRT-delay group, they were 88.6%, 81.4%, and 81.4% (P = 0.222). There were no significant differences in total histological response rates or local recurrence rates between the treatment groups. The good and moderate response group (mrTRG 1–3) had significantly better cumulative 1-, 3-, and 5-year OS and CSS compared to the poorer response group (mrTRG 4–5) (P = 0.023 for OS and P = 0.048 for CSS). Conclusion: Unfavorable MRI response is a sign of poor prognosis in LARC. SCRT-delay is comparable to LC-CRT concerning the oncological outcome.

Original languageEnglish
Article number23
Number of pages10
JournalINTERNATIONAL JOURNAL OF COLORECTAL DISEASE
Volume39
Issue number1
DOIs
Publication statusPublished - Jan 2024
Publication typeA1 Journal article-refereed

Keywords

  • Locally advanced rectal cancer
  • MRI response
  • Rectal cancer

Publication forum classification

  • Publication forum level 1

ASJC Scopus subject areas

  • Gastroenterology

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