Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy
<i>Background and Objectives</i>: A positive pathological circumferential resection margin is a key prognostic factor in rectal cancer surgery. The point of this prospective study was to see how well different MRI parameters could predict a positive pathological circumferential resection...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-02-01
|
| Series: | Medicina |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1648-9144/60/2/330 |
| _version_ | 1797297526869590016 |
|---|---|
| author | Cristian-Constantin Volovat Dragos-Viorel Scripcariu Diana Boboc Simona-Ruxandra Volovat Ingrid-Andrada Vasilache Corina Lupascu-Ursulescu Liliana Gheorghe Luiza-Maria Baean Constantin Volovat Viorel Scripcariu |
| author_facet | Cristian-Constantin Volovat Dragos-Viorel Scripcariu Diana Boboc Simona-Ruxandra Volovat Ingrid-Andrada Vasilache Corina Lupascu-Ursulescu Liliana Gheorghe Luiza-Maria Baean Constantin Volovat Viorel Scripcariu |
| author_sort | Cristian-Constantin Volovat |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: A positive pathological circumferential resection margin is a key prognostic factor in rectal cancer surgery. The point of this prospective study was to see how well different MRI parameters could predict a positive pathological circumferential resection margin (pCRM) in people who had been diagnosed with rectal adenocarcinoma, either on their own or when used together. <i>Materials and Methods</i>: Between November 2019 and February 2023, a total of 112 patients were enrolled in this prospective study and followed up for a 36-month period. MRI predictors such as circumferential resection margin (mCRM), presence of extramural venous invasion (mrEMVI), tumor location, and the distance between the tumor and anal verge, taken individually or combined, were evaluated with univariate and sensitivity analyses. Survival estimates in relation to a pCRM status were also determined using Kaplan–Meier analysis. <i>Results</i>: When individually evaluated, the best MRI predictor for the detection of a pCRM in the postsurgical histopathological examination is mrEMVI, which achieved a sensitivity (Se) of 77.78%, a specificity (Sp) of 87.38%, a negative predictive value (NPV) of 97.83%, and an accuracy of 86.61%. Also, the best predictive performance was achieved by a model that comprised all MRI predictors (mCRM+ mrEMVI+ anterior location+ < 4 cm from the anal verge), with an Se of 66.67%, an Sp of 88.46%, an NPV of 96.84%, and an accuracy of 86.73%. The survival rates were significantly higher in the pCRM-negative group (<i>p</i> < 0.001). <i>Conclusions</i>: The use of selective individual imaging predictors or combined models could be useful for the prediction of positive pCRM and risk stratification for local recurrence or distant metastasis. |
| first_indexed | 2024-03-07T22:21:33Z |
| format | Article |
| id | doaj.art-2f6b8b06ae594beaa52e9eae81a0ead9 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-07T22:21:33Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-2f6b8b06ae594beaa52e9eae81a0ead92024-02-23T15:26:47ZengMDPI AGMedicina1010-660X1648-91442024-02-0160233010.3390/medicina60020330Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging AccuracyCristian-Constantin Volovat0Dragos-Viorel Scripcariu1Diana Boboc2Simona-Ruxandra Volovat3Ingrid-Andrada Vasilache4Corina Lupascu-Ursulescu5Liliana Gheorghe6Luiza-Maria Baean7Constantin Volovat8Viorel Scripcariu9Department of Radiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Medical Oncology-Radiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Medical Oncology-Radiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Mother and Child Care, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Radiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Radiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Radiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Medical Oncology-Radiotherapy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Surgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania<i>Background and Objectives</i>: A positive pathological circumferential resection margin is a key prognostic factor in rectal cancer surgery. The point of this prospective study was to see how well different MRI parameters could predict a positive pathological circumferential resection margin (pCRM) in people who had been diagnosed with rectal adenocarcinoma, either on their own or when used together. <i>Materials and Methods</i>: Between November 2019 and February 2023, a total of 112 patients were enrolled in this prospective study and followed up for a 36-month period. MRI predictors such as circumferential resection margin (mCRM), presence of extramural venous invasion (mrEMVI), tumor location, and the distance between the tumor and anal verge, taken individually or combined, were evaluated with univariate and sensitivity analyses. Survival estimates in relation to a pCRM status were also determined using Kaplan–Meier analysis. <i>Results</i>: When individually evaluated, the best MRI predictor for the detection of a pCRM in the postsurgical histopathological examination is mrEMVI, which achieved a sensitivity (Se) of 77.78%, a specificity (Sp) of 87.38%, a negative predictive value (NPV) of 97.83%, and an accuracy of 86.61%. Also, the best predictive performance was achieved by a model that comprised all MRI predictors (mCRM+ mrEMVI+ anterior location+ < 4 cm from the anal verge), with an Se of 66.67%, an Sp of 88.46%, an NPV of 96.84%, and an accuracy of 86.73%. The survival rates were significantly higher in the pCRM-negative group (<i>p</i> < 0.001). <i>Conclusions</i>: The use of selective individual imaging predictors or combined models could be useful for the prediction of positive pCRM and risk stratification for local recurrence or distant metastasis.https://www.mdpi.com/1648-9144/60/2/330rectal adenocarcinomamagnetic resonance imagingpredictive performancecombined models |
| spellingShingle | Cristian-Constantin Volovat Dragos-Viorel Scripcariu Diana Boboc Simona-Ruxandra Volovat Ingrid-Andrada Vasilache Corina Lupascu-Ursulescu Liliana Gheorghe Luiza-Maria Baean Constantin Volovat Viorel Scripcariu Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy Medicina rectal adenocarcinoma magnetic resonance imaging predictive performance combined models |
| title | Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy |
| title_full | Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy |
| title_fullStr | Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy |
| title_full_unstemmed | Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy |
| title_short | Predicting the Feasibility of Curative Resection in Low Rectal Cancer: Insights from a Prospective Observational Study on Preoperative Magnetic Resonance Imaging Accuracy |
| title_sort | predicting the feasibility of curative resection in low rectal cancer insights from a prospective observational study on preoperative magnetic resonance imaging accuracy |
| topic | rectal adenocarcinoma magnetic resonance imaging predictive performance combined models |
| url | https://www.mdpi.com/1648-9144/60/2/330 |
| work_keys_str_mv | AT cristianconstantinvolovat predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT dragosviorelscripcariu predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT dianaboboc predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT simonaruxandravolovat predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT ingridandradavasilache predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT corinalupascuursulescu predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT lilianagheorghe predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT luizamariabaean predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT constantinvolovat predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy AT viorelscripcariu predictingthefeasibilityofcurativeresectioninlowrectalcancerinsightsfromaprospectiveobservationalstudyonpreoperativemagneticresonanceimagingaccuracy |