P20: Does Pre-Op Mri Following Neoadjuvant Long Course Chemo-Radiotherapy in Rectal Cancer Affect R0 Resection Rate?

Abstract

Introduction Neoadjuvant long course chemo-radiotherapy (LCCR) is the standard of care for locally advanced rectal cancer. In June 2013 this institution implemented preoperative MRI post LCCR in an attempt to improve the R0 resection rate. The aims of this projects were to audit the compliance with the new policy and to assess whether it had an impact on the R0 resection rate. Method All patients who underwent resection after LCCR between June 2013 and February 2017 had their clinical notes audited to assess compliance with the standard ‘all patients who have undergone LCCR should receive MRI imaging of the rectum unless clinically contraindicated’. To assess effectiveness of the intervention the R0 resection rate of patients who had received the preoperative MRI was compared to those who had not between the period January 2008 and February 2017. The data was entered and stored onto a larger departmental database so that it could be used in future for other projects. Result 33 out of 88 (37.5%) of eligible patients received post LCCR MRI rectum prior to resection although a further two patients had a preoperative CT scan. The R0 resection rate in patients who had pre-operative MRI was 88% compared to 89% in those who did not (p=1). Conclusion The rate of patients who received pre-operative MRI following LCCR was 37.5%. Whilst this shows significant room for improvement, data collected regarding effectiveness of the intervention shows that it makes no difference to R0 resection rate. Take-home message Pre-op MRI following LCCR does not improve R0 resection rate in locally advanced rectal cancer.