This article is more than 5 years old. Information may no longer be current.
MERCURY: MRI predicted outcomes for locally advanced rectal cancer
Patel UB. J Clin Oncol. 2011;doi:10.1200/JCO.2011.34.9068.
Click Here to Manage Email Alerts
Using MRI to evaluate responses to neoadjuvant therapy may be a tool to predict survival in patients with T3 or T4 rectal cancer.
In a prospective cohort study, 111 patients with advanced T3c, T3d or T4 tumors were assessed for response to neoadjuvant chemotherapy or radiotherapy. Researchers used MRI to evaluate circumferential resection margin status and tumor regression grade.
Multivariate analysis showed that tumor regression grade, as assessed by MRI, was independently significant for OS (HR=4.40; 95% CI, 1.65-11.7) and DFS (HR= 3.28; 95% CI, 1.22-8.80). Five-year OS for patients with poor MRI-assessed tumor regression grade was 27% compared with 72% for patients with a positive assessment. Five-year DFS results were similar (31% vs. 64%).
When researchers evaluated circumferential resection margin, they found that MRI results predicted local recurrence (HR=4.25; 95% CI, 1.45-12.51). Five-year local recurrence rate for patients with predicted involved MRI-assessed circumferential resection margin was 28% (95% CI, 13%-44%) compared with 12% (95% CI, 3%-22%) for patients with predicted clear MRI-assessed circumferential resection margin.
Five-year survival for patients with poor post-treatment pathologic T stage was 39% vs. 76% for patients with good post-treatment pathologic T stage; DFS for those patients was 38% vs. 84%. Local recurrence for those with poor post-treatment pathologic T stage was 27% vs. 6% (P=.018).
Pathologic node status did not predict outcomes.
 |
Follow HemOncToday.com on Twitter. |