Occurrence of peritoneal carcinomatosis in patients with rectal cancer undergoing staging pelvic MRI: clinical observations.
Diagnosis
Magnetic resonance imaging
Metastases
Peritoneum
Rectal cancer
Journal
European radiology
ISSN: 1432-1084
Titre abrégé: Eur Radiol
Pays: Germany
ID NLM: 9114774
Informations de publication
Date de publication:
Aug 2022
Aug 2022
Historique:
received:
14
01
2022
accepted:
25
02
2022
revised:
14
01
2022
pubmed:
24
3
2022
medline:
16
7
2022
entrez:
23
3
2022
Statut:
ppublish
Résumé
Describe the cumulative incidence (CUIN) of peritoneal carcinomatosis (PC) and survival in patients presenting with advanced rectal cancer at staging pelvic MRI. From 2013 to 2018, clinicopathologic records of patients with pretreatment rectal MRI clinical (c)T3c, cT3d, cT4a, and cT4b primary rectal adenocarcinoma were retrospectively reviewed by two radiologists. Standard MRI descriptors and pathologic stages were recorded. Recurrence-free (RFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Development of PC was explored using competing risk analysis. Differences in survival were compared using the log-rank test. Gray's test was used to test for differences in CUIN of PC. Three hundred forty-three patients (147 women; median age, 56 years) had MRI stages cT3cd, n = 170; cT4a, n = 40; and cT4b, n = 133. Median follow-up among survivors was 27 months (0.36-70 months). For M1 patients, OS differed only by cT stage (2-year OS: cT3 88.1%, cT4a 79.1%, cT4b 64.7%, p = 0.045). For M0 patients, OS and RFS differed only by pathological (p)T stage. We observed a statistically significant difference in the cumulative incidence of PC by cT stage (2-year CUIN: cT3 3.2%, cT4a 8.5%, cT4b 1.6%, p = 0.01), but not by pT stage. Seventy-nine patients (23%) presented with metastatic disease (M1), eight with PC (2.3%). Overall, eight patients presented with PC (cT4a: n = 4, other stages: n = 4) and 22 developed PC (cT4a: n = 5, other stages: n = 17). PC is uncommon in rectal cancer. MRI-based T stage exhibited an overall association with the cumulative incidence of PC, and descriptively, cT4a stage appears to have the highest CUIN. • In a retrospective study of 343 patients with rectal cancer undergoing baseline MRI and clinical follow-up, we found that peritoneal carcinomatosis was rare. • We observed a significant overall association between PC at presentation and cT stage that appeared to be driven by the higher proportion of cT4a patients presenting with PC. • Among patients that did not present with PC, we observed a significant overall association between time to PC and cT stage that may be driven by the higher cumulative incidence of PC in cT4a patients.
Identifiants
pubmed: 35319077
doi: 10.1007/s00330-022-08694-7
pii: 10.1007/s00330-022-08694-7
pmc: PMC9283216
mid: NIHMS1792329
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
5097-5105Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Informations de copyright
© 2022. The Author(s), under exclusive licence to European Society of Radiology.
Références
Gollub MJ, Maas M, Weiser M et al (2013) Recognition of the anterior peritoneal reflection at rectal MRI. AJR Am J Roentgenol 200:97–101
doi: 10.2214/AJR.11.7602
Sigurdsson HK, Korner H, Dahl O, Skarstein A, Soreide JA, Norwegian Colorectal Cancer G (2009) Rectal cancer with macroscopic peritoneal involvement--clinical challenges and consequences. Color Dis 11:838–844
doi: 10.1111/j.1463-1318.2008.01700.x
Gunderson LL, Jessup JM, Sargent DJ, Greene FL, Stewart A (2010) Revised tumor and node categorization for rectal cancer based on surveillance, epidemiology, and end results and rectal pooled analysis outcomes. J Clin Oncol 28:256–263
doi: 10.1200/JCO.2009.23.9194
Mercury-Study-Group (2006) Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ 333:779
doi: 10.1136/bmj.38937.646400.55
Shihab OC, How P, West N et al (2011) Can a novel MRI staging system for low rectal cancer aid surgical planning? Dis Colon Rectum 54:1260–1264
doi: 10.1097/DCR.0b013e31822abd78
Taylor FG, Quirke P, Heald RJ et al (2011) Preoperative high-resolution magnetic resonance imaging can identify good prognosis stage I, II, and III rectal cancer best managed by surgery alone: a prospective, multicenter, European study. Ann Surg 253:711–719
doi: 10.1097/SLA.0b013e31820b8d52
Merkel S, Mansmann U, Siassi M, Papadopoulos T, Hohenberger W, Hermanek P (2001) The prognostic inhomogeneity in pT3 rectal carcinomas. Int J Color Dis 16:298–304
doi: 10.1007/s003840100309
Jayne DG, Fook S, Loi C, Seow-Choen F (2002) Peritoneal carcinomatosis from colorectal cancer. Br J Surg 89:1545–1550
doi: 10.1046/j.1365-2168.2002.02274.x
Gollub MJ, Blazic I, Bates DDB et al (2019) Pelvic MRI after induction chemotherapy and before long-course chemoradiation therapy for rectal cancer: what are the imaging findings? Eur Radiol 29:1733–1742
doi: 10.1007/s00330-018-5726-2
Beets-Tan RGH, Lambregts DMJ, Maas M et al (2017) Magnetic resonance imaging for clinical management of rectal cancer: updated recommendations from the 2016 European Society of Gastrointestinal and Abdominal Radiology (ESGAR) consensus meeting. Eur Radiol. https://doi.org/10.1007/s00330-017-5026-2
Ogura A, Konishi T, Cunningham C et al (2018) Neoadjuvant (chemo)radiotherapy with total mesorectal excision only is not sufficient to prevent lateral local recurrence in enlarged nodes: results of the multicenter lateral node study of patients with low cT3/4 rectal cancer. J Clin Oncol. https://doi.org/10.1200/JCO.18.00032:JCO1800032
Ogura A, Konishi T, Beets GL et al (2019) Lateral nodal features on restaging magnetic resonance imaging associated with lateral local recurrence in low rectal cancer after neoadjuvant chemoradiotherapy or radiotherapy. JAMA Surg. https://doi.org/10.1001/jamasurg.2019.2172:e192172
Cercek A, Roxburgh CSD, Strombom P et al (2018) Adoption of total neoadjuvant therapy for locally advanced rectal cancer. JAMA Oncol 4:e180071
doi: 10.1001/jamaoncol.2018.0071
Quah HM, Chou JF, Gonen M et al (2008) Pathologic stage is most prognostic of disease-free survival in locally advanced rectal cancer patients after preoperative chemoradiation. Cancer 113:57–64
doi: 10.1002/cncr.23516
Hompes D, Tiek J, Wolthuis A et al (2012) HIPEC in T4a colon cancer: a defendable treatment to improve oncologic outcome? Ann Oncol 23:3123–3129
doi: 10.1093/annonc/mds173
Shepherd NA, Baxter KJ, Love SB (1995) Influence of local peritoneal involvement on pelvic recurrence and prognosis in rectal cancer. J Clin Pathol 48:849–855
doi: 10.1136/jcp.48.9.849
Wiliams GT QP, Shepherd NA. (2007) Dataset for colorectal cancer, 2nd revision.
Mitchard JR, Love SB, Baxter KJ, Shepherd NA (2010) How important is peritoneal involvement in rectal cancer? A prospective study of 331 cases. Histopathology 57:671–679
doi: 10.1111/j.1365-2559.2010.03687.x
Benson AB 3rd, Venook AP, Al-Hawary MM et al (2018) Rectal cancer, version 2.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Cancer Netw 16:874–901
doi: 10.6004/jnccn.2018.0061
Glynne-Jones R, Wyrwicz L, Tiret E et al (2017) Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 28:iv22-iv40