The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging
Abstract
Background: The aim was to determine the accuracy of preoperative magnetic resonance imaging (MRI) in the evaluation of pathological prognostic factors that influence local recurrence and survival in rectal cancer. Methods: Ninety-eight patients undergoing total mesorectal excision for biopsy-proven rectal cancer were assessed prospectively using high-resolution MRI for tumour (T) and nodal (N) staging using the tumour node metastasis classification, depth of extramural tumour spread, the presence or absence of extramural venous invasion, a threatened circumferential resection margin and serosal involvement at or above the peritoneal reflection. Preoperative magnetic resonance assessment of these prognostic factors was compared with histopathological findings in carefully matched whole-mount sections of the resection specimen. Results: There was 94 per cent weighted agreement (weighted κ = 0·67) between MRI and pathology assessment of T stage. Agreement between MRI and histological assessment of nodal status was 85 per cent (κ = 0·68). Although involvement of small veins by tumour was not discernible using MRI, large (calibre greater than 3 mm) extramural venous invasion was identified correctly in 15 of 18 patients (κ = 0·64). MRI predicted circumferential resection margin involvement with 92 per cent agreement (κ = 0·81). Seven of nine patients with peritoneal perforation by tumour (stage T4) were identified correctly using MRI. Conclusion: High-resolution MRI of the rectum allows preoperative identification of important surgical and pathological prognostic risk factors. This may allow both better selection and assessment of patients undergoing preoperative therapy.
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Metadata
- Authors
- Brown, G., Radcliffe, A. G., Newcombe, R. G., Dallimore, N. S., Bourne, M. W., & Williams, G. T.
- Venue
- British Journal of Surgery
- Publisher
- Oxford University Press (OUP)
- Published
- 2003-02-19
- Volume
- 90
- Issue
- 3
- Pages
- 355-364
- ISSN
- 0007-1323 (ISSN-L)
- 1365-2168
- OpenAlex
- W2107982027
- Cited by
- 734
- References
- 21
- FWCI
- 14.81
- Type
- journal article
- Language
- en
- Open access
- closed
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