caa a22 4500 445334401 CHVBK 20180317142749.0 cr unu---uuuuu 170323e20111101xx s 000 0 eng 10.1245/s10434-011-1776-2 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1776-2 MRI Predictive Factors for Long-Term Outcomes of Low Rectal Tumours [Elektronische Daten] [Oliver Shihab, Fiona Taylor, Gisella Salerno, Richard Heald, Philip Quirke, Brendan Moran, Gina Brown] Background: Low rectal cancers have poor outcomes. It has been suggested that low tumours are biologically more aggressive and tend to be more locally advanced at presentation. Pre-operative identification of prognostic factors will enable use of selective neoadjuvant therapies and possibly increase sphincter-sparing rates where oncologically safe. Methods: A subset of 101 patients with low rectal cancer (within 5cm of the anal verge) in a multicentre trial were studied. MRI images were reviewed by a senior radiologist, blinded to outcome. MRI-predicted tumour spread and MRI tumour regression grade (TRG) were analysed for 5-year recurrence and survival rates using a Cox regression model. Results: On univariate analysis, advanced MRI low rectal tumour stage correlated with greater incidence of recurrence (p=0.013) and death (p=0.029) compared with earlier stage tumours. Good MRI TRG score (good response to pre-operative therapy) correlated with significantly reduced tumour recurrence rates (p=0.008) and increased survival (p=0.008) versus the poor MRI TRG score group. On multivariate analysis, good MRI TRG score was associated with reduced recurrence (p=0.003) but not survival rates. Conclusions: This study confirms that MRI can be used to predict patients at increased risk of recurrence following surgery in low rectal cancer. This information can be used to direct pre-operative therapies and plan operative strategies. This is the first study to confirm the association between MRI TRG and long-term outcome. Poor response to neoadjuvant therapy can be used to plan use of further therapies prior to surgery to attempt to improve outcome. Society of Surgical Oncology, 2011 Shihab Oliver Colorectal Research, Pelican Cancer Foundation, Basingstoke, Hampshire, UK aut Taylor Fiona Department of Colorectal Surgery, Mayday University Hospital, London, UK aut Salerno Gisella Department of Colorectal Surgery, Frimley Park Hospital, Frimley, UK aut Heald Richard Colorectal Research, Pelican Cancer Foundation, Basingstoke, Hampshire, UK aut Quirke Philip Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, Leeds, UK aut Moran Brendan Colorectal Research Unit, North Hampshire Hospital, Basingstoke, Hampshire, UK aut Brown Gina Department of Radiology, The Royal Marsden Hospital, Sutton, Surrey, UK aut Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3278-3284 1068-9265 18:12<3278 2011 18 10434 https://doi.org/10.1245/s10434-011-1776-2 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1776-2 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shihab Oliver Colorectal Research, Pelican Cancer Foundation, Basingstoke, Hampshire, UK aut NATIONALLICENCE 700 1- Taylor Fiona Department of Colorectal Surgery, Mayday University Hospital, London, UK aut NATIONALLICENCE 700 1- Salerno Gisella Department of Colorectal Surgery, Frimley Park Hospital, Frimley, UK aut NATIONALLICENCE 700 1- Heald Richard Colorectal Research, Pelican Cancer Foundation, Basingstoke, Hampshire, UK aut NATIONALLICENCE 700 1- Quirke Philip Pathology and Tumour Biology, Leeds Institute of Molecular Medicine, Leeds, UK aut NATIONALLICENCE 700 1- Moran Brendan Colorectal Research Unit, North Hampshire Hospital, Basingstoke, Hampshire, UK aut NATIONALLICENCE 700 1- Brown Gina Department of Radiology, The Royal Marsden Hospital, Sutton, Surrey, UK aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/12(2011-11-01), 3278-3284 1068-9265 18:12<3278 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer