Magnetic Resonance Imaging-Detected High-Risk Markers in Rectal Cancer Patients With a Pathologic Complete Response...

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Pathologic complete response (pCR) is a crucial prognostic indicator in rectal cancer.
• A subset of rectal cancer patients achieving pCR still experience recurrence or poor outcomes.
• Identifying high-risk pCR patients and the role of adjuvant therapy remain subjects of debate.

Purpose of the Study:

• To evaluate pretreatment magnetic resonance imaging (MRI) markers for their prognostic value in rectal cancer patients with pCR.
• To identify high-risk pCR patients based on MRI findings.
• To assess the efficacy of adjuvant therapy in this patient cohort.

Main Methods:

• Retrospective analysis of 384 rectal cancer patients who achieved pCR between 2010 and 2019.
• Assessment of various pretreatment MRI markers for prognostic significance.
• Estimation of disease-free survival (DFS) and overall survival (OS) using Kaplan-Meier curves and log-rank tests.

Main Results:

• Magnetic resonance with tumor deposits (mrTD) on pretreatment MRI was identified as the strongest prognostic factor.
• Positive mrTD (mrTD+) significantly increased recurrence risk (aHR, 5.16) and reduced OS.
• Adjuvant therapy demonstrated no significant improvement in prognosis for pCR patients, irrespective of mrTD status.

Conclusions:

• Pretreatment mrTD is a critical prognostic marker for identifying high-risk rectal cancer patients with pCR.
• Adjuvant therapy does not appear to benefit pCR patients, suggesting a need for tailored treatment strategies.
• Personalized treatment approaches are essential for optimizing outcomes in rectal cancer patients achieving pCR.