A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases

Muhammed R.S. Siddiqui, Constantinos Simillis, Chris Hunter, Manish Chand, Jemma Bhoday, Aurelie Garant, Te Vuong, Giovanni Artho, Shahnawaz Rasheed, Paris Tekkis, Al Mutaz Abulafi, Gina Brown

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background:Pathological extramural vascular invasion (EMVI) is an independent prognostic factor in rectal cancer, but can also be identified on MRI-detected extramural vascular invasion (mrEMVI). We perform a meta-analysis to determine the risk of metastatic disease at presentation and after surgery in mrEMVI-positive patients compared with negative tumours.Methods:Electronic databases were searched from January 1980 to March 2016. Conventional meta-analytical techniques were used to provide a summative outcome. Quality assessment of the studies was performed.Results:Six articles reported on mrEMVI in 1262 patients. There were 403 patients in the mrEMVI-positive group and 859 patients in the mrEMVI-negative group. The combined prevalence of mrEMVI-positive tumours was 0.346(range=0.198-0.574). Patients with mrEMVI-positive tumours presented more frequently with metastases compared to mrEMVI-negative tumours (fixed effects model: odds ratio (OR)=5.68, 95% confidence interval (CI) (3.75, 8.61), z=8.21, df=2, P<0.001). Patients who were mrEMVI-positive developed metastases more frequently during follow-up (random effects model: OR=3.91, 95% CI (2.61, 5.86), z=6.63, df=5, P<0.001).Conclusions:MRI-detected extramural vascular invasion is prevalent in one-third of patients with rectal cancer. MRI-detected extramural vascular invasion is a poor prognostic factor as evidenced by the five-fold increased rate of synchronous metastases, and almost four-fold ongoing risk of developing metastases in follow-up after surgery.

Original languageEnglish (US)
Pages (from-to)1513-1519
Number of pages7
JournalBritish Journal of Cancer
Volume116
Issue number12
DOIs
StatePublished - Jun 6 2017
Externally publishedYes

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Rectal Neoplasms
Blood Vessels
Meta-Analysis
Neoplasm Metastasis
Neoplasms
Odds Ratio
Confidence Intervals
Databases

Keywords

  • extramural vascular invasion
  • MRI
  • rectal cancer

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases. / Siddiqui, Muhammed R.S.; Simillis, Constantinos; Hunter, Chris; Chand, Manish; Bhoday, Jemma; Garant, Aurelie; Vuong, Te; Artho, Giovanni; Rasheed, Shahnawaz; Tekkis, Paris; Abulafi, Al Mutaz; Brown, Gina.

In: British Journal of Cancer, Vol. 116, No. 12, 06.06.2017, p. 1513-1519.

Research output: Contribution to journalArticle

Siddiqui, MRS, Simillis, C, Hunter, C, Chand, M, Bhoday, J, Garant, A, Vuong, T, Artho, G, Rasheed, S, Tekkis, P, Abulafi, AM & Brown, G 2017, 'A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases', British Journal of Cancer, vol. 116, no. 12, pp. 1513-1519. https://doi.org/10.1038/bjc.2017.99
Siddiqui, Muhammed R.S. ; Simillis, Constantinos ; Hunter, Chris ; Chand, Manish ; Bhoday, Jemma ; Garant, Aurelie ; Vuong, Te ; Artho, Giovanni ; Rasheed, Shahnawaz ; Tekkis, Paris ; Abulafi, Al Mutaz ; Brown, Gina. / A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases. In: British Journal of Cancer. 2017 ; Vol. 116, No. 12. pp. 1513-1519.
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abstract = "Background:Pathological extramural vascular invasion (EMVI) is an independent prognostic factor in rectal cancer, but can also be identified on MRI-detected extramural vascular invasion (mrEMVI). We perform a meta-analysis to determine the risk of metastatic disease at presentation and after surgery in mrEMVI-positive patients compared with negative tumours.Methods:Electronic databases were searched from January 1980 to March 2016. Conventional meta-analytical techniques were used to provide a summative outcome. Quality assessment of the studies was performed.Results:Six articles reported on mrEMVI in 1262 patients. There were 403 patients in the mrEMVI-positive group and 859 patients in the mrEMVI-negative group. The combined prevalence of mrEMVI-positive tumours was 0.346(range=0.198-0.574). Patients with mrEMVI-positive tumours presented more frequently with metastases compared to mrEMVI-negative tumours (fixed effects model: odds ratio (OR)=5.68, 95{\%} confidence interval (CI) (3.75, 8.61), z=8.21, df=2, P<0.001). Patients who were mrEMVI-positive developed metastases more frequently during follow-up (random effects model: OR=3.91, 95{\%} CI (2.61, 5.86), z=6.63, df=5, P<0.001).Conclusions:MRI-detected extramural vascular invasion is prevalent in one-third of patients with rectal cancer. MRI-detected extramural vascular invasion is a poor prognostic factor as evidenced by the five-fold increased rate of synchronous metastases, and almost four-fold ongoing risk of developing metastases in follow-up after surgery.",
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T1 - A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases

AU - Siddiqui, Muhammed R.S.

AU - Simillis, Constantinos

AU - Hunter, Chris

AU - Chand, Manish

AU - Bhoday, Jemma

AU - Garant, Aurelie

AU - Vuong, Te

AU - Artho, Giovanni

AU - Rasheed, Shahnawaz

AU - Tekkis, Paris

AU - Abulafi, Al Mutaz

AU - Brown, Gina

PY - 2017/6/6

Y1 - 2017/6/6

N2 - Background:Pathological extramural vascular invasion (EMVI) is an independent prognostic factor in rectal cancer, but can also be identified on MRI-detected extramural vascular invasion (mrEMVI). We perform a meta-analysis to determine the risk of metastatic disease at presentation and after surgery in mrEMVI-positive patients compared with negative tumours.Methods:Electronic databases were searched from January 1980 to March 2016. Conventional meta-analytical techniques were used to provide a summative outcome. Quality assessment of the studies was performed.Results:Six articles reported on mrEMVI in 1262 patients. There were 403 patients in the mrEMVI-positive group and 859 patients in the mrEMVI-negative group. The combined prevalence of mrEMVI-positive tumours was 0.346(range=0.198-0.574). Patients with mrEMVI-positive tumours presented more frequently with metastases compared to mrEMVI-negative tumours (fixed effects model: odds ratio (OR)=5.68, 95% confidence interval (CI) (3.75, 8.61), z=8.21, df=2, P<0.001). Patients who were mrEMVI-positive developed metastases more frequently during follow-up (random effects model: OR=3.91, 95% CI (2.61, 5.86), z=6.63, df=5, P<0.001).Conclusions:MRI-detected extramural vascular invasion is prevalent in one-third of patients with rectal cancer. MRI-detected extramural vascular invasion is a poor prognostic factor as evidenced by the five-fold increased rate of synchronous metastases, and almost four-fold ongoing risk of developing metastases in follow-up after surgery.

AB - Background:Pathological extramural vascular invasion (EMVI) is an independent prognostic factor in rectal cancer, but can also be identified on MRI-detected extramural vascular invasion (mrEMVI). We perform a meta-analysis to determine the risk of metastatic disease at presentation and after surgery in mrEMVI-positive patients compared with negative tumours.Methods:Electronic databases were searched from January 1980 to March 2016. Conventional meta-analytical techniques were used to provide a summative outcome. Quality assessment of the studies was performed.Results:Six articles reported on mrEMVI in 1262 patients. There were 403 patients in the mrEMVI-positive group and 859 patients in the mrEMVI-negative group. The combined prevalence of mrEMVI-positive tumours was 0.346(range=0.198-0.574). Patients with mrEMVI-positive tumours presented more frequently with metastases compared to mrEMVI-negative tumours (fixed effects model: odds ratio (OR)=5.68, 95% confidence interval (CI) (3.75, 8.61), z=8.21, df=2, P<0.001). Patients who were mrEMVI-positive developed metastases more frequently during follow-up (random effects model: OR=3.91, 95% CI (2.61, 5.86), z=6.63, df=5, P<0.001).Conclusions:MRI-detected extramural vascular invasion is prevalent in one-third of patients with rectal cancer. MRI-detected extramural vascular invasion is a poor prognostic factor as evidenced by the five-fold increased rate of synchronous metastases, and almost four-fold ongoing risk of developing metastases in follow-up after surgery.

KW - extramural vascular invasion

KW - MRI

KW - rectal cancer

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