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European Radiology
Erschienen in:

15.05.2021 | Oncology

The prognostic value of MRI-detected extramural vascular invasion (mrEMVI) for rectal cancer patients treated with neoadjuvant therapy: a meta-analysis

verfasst von: Silin Chen, Ning Li, Yuan Tang, Jinming Shi, Ying Zhao, Huiying Ma, Shulian Wang, Ye-xiong Li, Jing Jin

Erschienen in: European Radiology | Ausgabe 12/2021

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Abstract

Objectives

The purpose of this meta-analysis was to evaluate the prognostic value of MRI-detected extramural vascular invasion (mrEMVI) and mrEMVI after neoadjuvant therapy (ymrEMVI) in rectal cancer patients receiving neoadjuvant therapy.

Methods

A systematic search of the PubMed, Web of Science, Embase, and Cochrane Library databases was carried out up to June 2020. Studies that evaluated mrEMVI, used treatment with neoadjuvant therapy, and reported survival were included. The time-to-event outcomes (OS and DFS rates) are expressed as hazard ratios (HRs) with 95% confidence intervals (CIs). If the HR was not reported in the study, it was calculated from the survival curve using methods according to Parmar’s recommendation. The Newcastle-Ottawa scale was used to assess the methodological quality of the studies included in the meta-analysis.

Results

A total of 2237 patients from 11 studies were included, and the pooled analysis of the overall results from eight studies showed that patients who were mrEMVI positive at baseline had significantly worse disease-free survival (DFS) (random-effects model: HR = 2.50 [1.84, 3.14]; Z = 5.83, p < 0.00001). The pooled analysis of the overall results from six studies showed that patients who were ymrEMVI positive following neoadjuvant therapy had significantly worse DFS (random-effects model: HR = 2.24 [1.73, 2.90], Z = 6.12, p < 0.00001). Patients with mrEMVI positivity at baseline were also associated with worse overall survival (OS) (random-effects model: HR = 1.93 [1.36, 2.73]; Z = 3.71, p < 0.00001).

Conclusion

mrEMVI and ymrEMVI positivity are poor prognostic factors for rectal cancer patients treated with neoadjuvant therapy. The precise evaluation of EMVI may contribute to designing individualised treatments and improving patient outcomes.

Key Points

• Extramural vascular invasion (EMVI) is a prognostic factor for rectal cancer.
• MRI can be used to evaluate EMVI status before (mrEMVI) and after neoadjuvant therapy (ymrEMVI).
• The evaluation of mrEMVI and ymrEMVI in neoadjuvant therapy would provide an early assessment of patient prognosis.
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Metadaten
Titel
The prognostic value of MRI-detected extramural vascular invasion (mrEMVI) for rectal cancer patients treated with neoadjuvant therapy: a meta-analysis
verfasst von
Silin Chen
Ning Li
Yuan Tang
Jinming Shi
Ying Zhao
Huiying Ma
Shulian Wang
Ye-xiong Li
Jing Jin
Publikationsdatum
15.05.2021
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 12/2021
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-021-07981-z

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