Oncologic Outcomes Associated With MRI-detected Extramural Venous Invasion (mrEMVI) in Rectal Cancer: A Systematic...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• MRI-detected extramural venous invasion (EMVI) is increasingly recognized as a prognostic factor in rectal cancer.
• However, its reporting remains inconsistent across institutions.

Purpose of the Study:

• To highlight the prognostic significance of pre- and post-treatment MRI-detected EMVI.
• To demonstrate their role as independent predictors of adverse oncologic outcomes in rectal cancer patients.

Main Methods:

• Systematic review adhering to PRISMA guidelines.
• Searched CENTRAL, MEDLINE, PubMed, and Embase databases (January 2002 - January 2020).
• Analyzed data on Disease-Free Survival (DFS), Overall Survival (OS), positive resection margin, and synchronous metastases.

Main Results:

• Seventeen studies with 3821 patients were included.
• Pre-treatment EMVI positivity correlated with higher recurrence (HR 2.30), lower OS (HR 1.68), and increased synchronous metastasis (RR 4.11).
• Post-treatment EMVI positivity was linked to lower DFS (HR 2.04) and higher positive resection margin rates (RR 2.95).

Conclusions:

• Oncologic outcomes are significantly worse in rectal cancer patients with pre- and post-treatment MRI-detected EMVI positivity.
• Consistent reporting of MRI-detected EMVI in rectal cancer staging is crucial.
• This finding can guide the targeted use of additional systemic therapies.