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- Title
A new magnetic resonance imaging tumour response grading scheme for locally advanced rectal cancer.
- Authors
Pang, Xiaolin; Xie, Peiyi; Yu, Li; Chen, Haiyang; Zheng, Jian; Meng, Xiaochun; Wan, Xiangbo
- Abstract
<bold>Background: </bold>The potential of using magnetic resonance image tumour-regression grading (MRI-TRG) system to predict pathological TRG is debatable for locally advanced rectal cancer treated by neoadjuvant radiochemotherapy.<bold>Methods: </bold>Referring to the American Joint Committee on Cancer/College of American Pathologists (AJCC/CAP) TRG classification scheme, a new four-category MRI-TRG system based on the volumetric analysis of the residual tumour and radiochemotherapy induced anorectal fibrosis was established. The agreement between them was evaluated by Kendall's tau-b test, while Kaplan-Meier analysis was used to calculate survival outcomes.<bold>Results: </bold>In total, 1033 patients were included. Good agreement between MRI-TRG and AJCC/CAP TRG classifications was observed (k = 0.671). Particularly, as compared with other pairs, MRI-TRG 0 displayed the highest sensitivity [90.1% (95% CI: 84.3-93.9)] and specificity [92.8% (95% CI: 90.4-94.7)] in identifying AJCC/CAP TRG 0 category patients. Except for the survival ratios that were comparable between the MRI-TRG 0 and MRI-TRG 1 categories, any two of the four categories had distinguished 3-year prognosis (all P < 0.05). Cox regression analysis further proved that the MRI-TRG system was an independent prognostic factor (all P < 0.05).<bold>Conclusion: </bold>The new MRI-TRG system might be a surrogate for AJCC/CAP TRG classification scheme. Importantly, the system is a reliable and non-invasive way to identify patients with complete pathological responses.
- Subjects
RECTUM tumors; MAGNETIC resonance imaging; TREATMENT effectiveness; COMBINED modality therapy; TUMOR grading
- Publication
British Journal of Cancer, 2022, Vol 127, Issue 2, p268
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-022-01801-x