Prognostic value of combined preoperative MRI and postoperative pathological assessment of lymph node metastasis in rectal cancer patients
10.3969/j.issn.1006-5725.2024.11.016
- VernacularTitle:联合术前MRI和术后病理评估淋巴结转移在直肠癌患者预后预测中的价值
- Author:
Zhiming ZENG
1
,
2
,
3
;
Pan ZHU
;
Decai MA
;
Xiaohui DI
;
Guiting LI
;
Wenbin ZHOU
;
Ximin PAN
Author Information
1. 中山大学附属第六医院放射诊断科(广州 510655)
2. 广东省结直肠盆底疾病研究重点实验室(广州 510655)
3. 广州市黄埔区中六生物医学创新研究院(广州 510655)
- Keywords:
rectal cancer;
MRI;
lymph node;
prognosis
- From:
The Journal of Practical Medicine
2024;40(11):1560-1567
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of combining preoperative magnetic resonance imaging(MRI)and postoperative pathological assessment of lymph node metastasis in predicting overall survival in rectal cancer patients.Methods This retrospective study collected clinical,pathological and image information of 2610 patients histopathologically confirmed with rectal adenocarcinoma at the Sixth Affiliated Hospital of Sun Yat-sen University between January 2016 and December 2021.All patients underwent MRI scans and were divided into three groups according to lymph node status assessed by preoperative MRI(MRIN)and postoperative pathology(PN):MRIN+but PN-(MRIN+group),PN+but MRIN-(PN+group),MRIN+and PN+(MRI-PN+group).Inverse probability weighting(IPW)was used to adjust for confounding factors.Kaplan-Meier curves were used to estimate overall survival and log-rank tests were used to compare the difference.Univariate Cox regression models were used to analyze the correlation between tumor characteristics and overall survival,and bidirectional stepwise Cox regression models were used to identify independent risk factors for overall survival.Results The MRI-PN+group showed higher tumor staging,more frequent perineural invasion,more distant metastases,and a higher risk of death compared to the P N+group and MRIN+group(all P＜0.05).Kaplan-Meier curves showed that the 3-year survival rates for the MRIN+group,PN+group,and MRI-PN+group were 90.5%,79.1%,and 76.4%,respectively;the 5-year survival rates were 85.7%,71.5%,and 59.2%,respectively.Stepwise Cox regression showed that age,tumor location,carcino-embryonic antigen,carbohydrate antigen 19-9,lymph nodes number,pathological tumor stage,lymphovascular invasion,perineural invasion,distant metastasis,neoadjuvant therapy and adjuvant therapy,and MRI-pathology lymph node status were independent risk factors for overall survival in rectal cancer(all P＜0.05).Conclusion Evaluating the lymph node status by combining preoperative MRI and postoperative pathology helps predict overall survival in rectal cancer patients more accurately.
