Comparison of magnetic resonance imaging and histopathological response to chemoradiotherapy in locally advanced rectal cancer
Background Magnetic resonance imaging (MRI) methods for chemoradiotherapy (CRT) response assessment of rectal cancer include posttreatment T staging (ymrT), tumor regression grading (mrTRG), volume reduction posttreatment, and modified RECIST measurement. We compared these methods in identifying good versus poor responders with the histopathological standards of T stage (ypT) and tumor regression grading (TRG). Methods A total of 86 patients underwent CRT in a prospective phase II trial for MRI-defined locally advanced rectal cancer. Two readers independently assessed MRIs for ymrT, mrTRG, volume change, and RECIST. Parameters for each case were categorized as good or poor response and analyzed against ypT and TRG by univariate logistic regression. Results A total of 83 patients had evaluable imaging, and 78 had final pathology (five did not undergo surgery). Of these, 34 patients had good response (ypT0-3a) and 44 had poor response (>ypT3a). Also, 27 patients had favorable pathologic TRG (predominant fibrosis) and 51 had unfavorable TRG (predominant tumor). Good mrTRG and ymr P = 0.001) associated with favorable pathology odds ratio [OR] = 16.11 (95 % confidence interval [95 % CI]: 3.3677.29) and 17.50 (95 % CI: 5.3856.89), respectively. RECIST measurements and volume reduction of >80 % showed an OR of 3.23 (95 % CI: 1.149.17), 4.25 (95 % CI: 0.9215.45), respectively, for a good ypT score (P = 0.028), but there was no association for histopathological TRG. Conclusion Favorable and unfavorable histopathology are predicted by both ymrT and mrTRG, and we recommend these parameters for post-treatment assessment of rectal cancers treated with CRT. Annals of Surgical Oncology Annals of Surgical Oncology Look Inside Article Metrics 29 Citations Co-published with Society of Surgical Oncology Society of Surgical Oncology Other actions Export citation Register for Journal Updates About This Journal Reprints and Permissions Add to Papers Share Share this content on Facebook Share this content on Twitter Share this content on LinkedIn
Source (journal)
Annals of surgical oncology. - Philadelphia, Pa
Philadelphia, Pa : 2012
19:9(2012), p. 2842-2852
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Creation 23.04.2015
Last edited 03.12.2017