TY  - JOUR
ID  - discovery10045271
SN  - 1532-1827
N1  - This version is the version of record. For information on re-use, please refer to the publisher?s terms and conditions. Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0).
EP  - 1519
JF  - British Journal of Cancer
AV  - public
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.
VL  - 116
SP  - 1513
UR  - http://dx.doi.org/10.1038/bjc.2017.99
KW  - Blood Vessels
KW  -  Humans
KW  -  Magnetic Resonance Imaging
KW  -  Neoplasm Invasiveness
KW  -  Neoplasm Metastasis
KW  -  Rectal Neoplasms
KW  -  Risk Factors
TI  - A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases
IS  - 12
Y1  - 2017/06/06/
A1  - Siddiqui, MRS
A1  - Simillis, C
A1  - Hunter, C
A1  - Chand, M
A1  - Bhoday, J
A1  - Garant, A
A1  - Vuong, T
A1  - Artho, G
A1  - Rasheed, S
A1  - Tekkis, P
A1  - Abulafi, A-M
A1  - Brown, G
ER  -