Magnetic Resonance Imaging Prediction of an Involved Surgical Resection Margin in Low Rectal Cancer

Salerno, Gisella; Daniels, Ian R.; Moran, Brendan; Heald, R. J.; Thomas, Karen; Brown, Gina

doi:10.1007/dcr.0b013e3181a0a37e

Cited by 73 publications

(57 citation statements)

References 19 publications

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“…In detail, patients with suspected tumor tissue (primary tumor or affected lymph node) over 1 mm away from the circumferential resection margin (CRM) and MRI-predicted T1/T2/T3a/T3b regardless of lymph node status are considered as Bgood prognosisâ nd can safely be treated by primary surgery with adjuvant chemotherapy depending on lymph node status [16]. In addition, lower rectal tumors <5 cm from the anal verge are also categorized as good if not encroaching into the intersphincteric plane or levator muscles [17]. Even in the MERCURY concept, MRIpositive lymph nodes remain an important issue.…”

Section: Discussionmentioning

confidence: 99%

Clinical relevance of morphologic MRI criteria for the assessment of lymph nodes in patients with rectal cancer

Doyon

Attenberger

Dinter

et al. 2015

Int J Colorectal Dis

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Section: Discussionmentioning

confidence: 99%

Clinical relevance of morphologic MRI criteria for the assessment of lymph nodes in patients with rectal cancer

Doyon

Attenberger

Dinter

et al. 2015

Int J Colorectal Dis

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“…Moreover, Salerno et al . reported that MRI can predict invasion to the ISS 62. The utility of MRI has been emphasized for facilitating a successful operation with negative CRM 63, 64.…”

Section: Discussionmentioning

confidence: 99%

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Shirouzu

Murakami

Akagi

2017

Annals of Gastroent Surgery

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Intersphincteric resection (ISR) has rapidly increased worldwide including laparoscopic surgery. However, there are some concerns for the definition of ISR, surgical technique, oncological outcome, anal function, and quality of life (QoL). The aim of the present study is to evaluate those issues. A review of this surgical technique was carried out by searching English language literature of the PubMed online database and appropriate articles were identified. With regard to open‐ISR, the morbidity rate ranged from 7.5% to 38.3%, with lower mortality rates. Local recurrence rates varied widely from 0% to 22.7%, with a mean follow‐up duration of 40–94 months. Disease‐free and overall 5‐year survival rates were 68–86% and 76–97%, respectively. Those outcomes were equivalent to laparoscopic‐ISR. Surgical and oncological outcomes of ISR were generally acceptable. However, accurate evaluation of anal function and QoL was difficult because of a lack of standard assessment of various patient‐related factors. The surgical and oncological outcomes after ISR seem to be acceptable. The ISR technique seems to be valid as an alternative to abdominoperineal resection in selected patients with a very low rectal cancer. However, both necessity for ISR and expectations of QoL impairment as a result of functional disorder should be fully discussed with patients before surgery.

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“…This may be one limitation of our study. Recently, in order to enhance the accuracy of MRI in staging low rectal cancer, some studies proposed a novel MRI staging technique, which was based on the relationship of the tumor to the levators and individual components of the sphincter complex [53,54,55]. However, the benefit of the new staging technique is not clear and larger prospective studies are needed to confirm its benefit.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of MRI for the Assessment of Mesorectal Fascia Involvement in Patients with Rectal Cancer: A Systematic Review and Meta-Analysis

Xie

Zhou

et al. 2014

Dig Surg

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Aims: Defining the most appropriate definition of mesorectal fascia involvement (MRF+) by reviewing literature and using new inclusion criteria to re-evaluate the effectiveness of MRI in the assessment of MRF+ for rectal cancer. Methods: PubMed, Medline, Embase, and the Cochrane Library databases were electronically searched from 1999 to 2012. The bivariate random effects model was used to estimate the pooled outcomes of each subgroup. The definition of MRF+ in MRI and the influence of neoadjuvant chemoradiotherapy (neo-ChRT) were especially discussed. Results: Fourteen studies involving 1,600 patients were included. Different definitions of MRF+ (≤1, ≤2 and ≤5 mm) in MRI exhibited different pooled sensitivity (76, 79 and 92%), specificity (88, 66 and 48%) and diagnostic odds ratio (DOR) (22.4, 6.6 and 16.0). The definition of MRF+ at ≤1 mm showed the highest DOR. The specificity (88 vs. 93%, p = 0.026) and DOR (15.5 vs. 39.0, p = 0.001) were lower in patients who underwent neo-ChRT than those who did not while using ≤1 mm as the definition of MRF+. However, the sensitivity showed no significant difference (67 vs. 74%, p = 0.129). Conclusions: MRI is valuable for the assessment of MRF. The most appropriate definition of MRF+ in MRI is ≤1 mm. The effectiveness is higher in patients who did not undergo neo-ChRT.

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Magnetic Resonance Imaging Prediction of an Involved Surgical Resection Margin in Low Rectal Cancer

Abstract: Significant magnetic resonance imaging positive resection margin predictors are tumor into or beyond the intersphincteric plane and magnetic resonance imaging tumor regression grade.

Cited by 73 publications

References 19 publications

Clinical relevance of morphologic MRI criteria for the assessment of lymph nodes in patients with rectal cancer

Clinical relevance of morphologic MRI criteria for the assessment of lymph nodes in patients with rectal cancer

Intersphincteric resection for very low rectal cancer: A review of the updated literature

Effectiveness of MRI for the Assessment of Mesorectal Fascia Involvement in Patients with Rectal Cancer: A Systematic Review and Meta-Analysis

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