肛门癌治疗前磁共振成像：mrT、mrN 和新分期参数的大规模评估。
Pre-treatment magnetic resonance imaging in anal cancer: large-scale evaluation of mrT, mrN and novel staging parameters.
发表日期：2024 Aug 21
作者：
Hema Sekhar, Rohit Kochhar, Bernadette Carrington, Thomas Kaye, Damian Tolan, Lee Malcomson, Mark P Saunders, Matthew Sperrin, David Sebag-Montefiore, Marcel van Herk, Andrew G Renehan
来源：
BRITISH JOURNAL OF CANCER
摘要：
对于肛门鳞状细胞癌（SCCA）患者，建议在放化疗（CRT）之前使用磁共振（MR）成像进行治疗前分期，但缺乏对其分期表现的大规模评估。我们重新对 228 名在英国一家癌症中心连续接受 CRT 治疗（2006-2015 年）的非转移性 SCCA 患者的治疗前 MR 进行了表征。我们根据肿瘤大小 (mrTr) 和淋巴结受累 (mrN) 得出 TN 分期，并另外表征了 TN 之外的新特征，如壁外血管侵犯 (mrEMVI) 和肿瘤信号异质性 (mrTSH)。主要结局是 5 年总生存率 (OS) 和 3 年局部区域失败 (LRF)。事件发生时间分析使用 Kaplan-Meier 估计；风险比 (HR) 和置信区间 (CI) 源自 Cox 模型。中位随访时间为 60.9 个月，5 年 OS 为 74%。较差的 OS 与 mrT 增加（HR：1.12/cm [95% CI：1.07-1.33]）、淋巴结阳性（HR 2.08 [95% CI 1.23-3.52]）和 mrEMVI（HR 3.66 [95% CI：1.88-1.88]）相关。 7.41]）。 3年LRF率为16.5%。 LRF 增加与 mrT（HR：1.43/cm [95% CI：1.26-1.63]）、淋巴结阳性（HR 2.70 [95% CI 1.39-5.24]）和 mrTSH（HR 2.66 [95% CI 1.29-5.48]）增加相关。 ]).在 SCCA 中，研究表明 mrT 和 mrN 分期具有预后意义，而 mrEMVI 和 mrTSH 可能是新的预后因素。© 2024。作者。
In patients with squamous cell carcinoma of the anus (SCCA), magnetic resonance (MR) imaging is recommended for pre-treatment staging prior to chemo-radiotherapy (CRT), but large-scale evaluation of its staging performance is lacking.We re-characterised pre-treatment MRs from 228 patients with non-metastatic SCCA treated consecutively by CRT (2006-2015) at one UK cancer centre. We derived TN staging from tumour size (mrTr) and nodal involvement (mrN), and additionally characterised novel beyond TN features such as extramural vascular invasion (mrEMVI) and tumour signal heterogeneity (mrTSH). Primary outcomes were 5-year overall survival (OS) and 3-year loco-regional failure (LRF). Time-to-event analyses used Kaplan-Meier estimates; Hazard Ratios (HRs) with confidence intervals (CIs) were derived from Cox models.With a median follow up of 60.9 months, 5-year OS was 74%. Poor OS was associated with increasing mrT (HR: 1.12 per cm [95% CI: 1.07-1.33]), nodal positivity (HR 2.08 [95% CI 1.23-3.52]) and mrEMVI (HR 3.66 [95% CI: 1.88-7.41]). 3-year LRF rate was 16.5%. Increased LRF was associated with increasing mrT (HR: 1.43 per cm [95% CI: 1.26-1.63]), nodal positivity (HR 2.70 [95% CI 1.39-5.24]) and mrTSH (HR 2.66 [95% CI 1.29-5.48]).In SCCA, the study demonstrates that mrT and mrN stages are prognostic, while mrEMVI and mrTSH may be novel prognostic factors.© 2024. The Author(s).