Colorectal cancer is the 3rd most incident malignancy globally and 4th in cancer-related death [1,2]. Rectal cancer represents up to 44% of all colorectal malignancies .
Locally-advanced rectal cancer (LARC) pose a particular challenge as it is locally progressed but not metastatic yet . Fig. 1.
Neoadjuvant chemo-radiotherapy (nCRT) and total mesorectal excision (TME) have achieved good local control of LARC but have not affected overall or disease-free survival. Metastases are the main cause of treatment failure and early metastases, especially during the first 2...
Methods and materials
Patient population:We retrospective and consecutively selected all patients with LARC treated at our institution from May 2008-June 2015. Our institution is a national reference centre for rectal cancer. All cases were adenocarcinoma, with pre and post-nCRT MRIs, and at least 2 years of follow-up after surgery.Final outcome was 2 years of metastases-free survival. Diagnosis, treatment, and follow-up were performed in our institution. Inclusion and exclusion criteria are in Table 1. The institutional review board of our centre approved the study and waived the requirement for...
Sample demographics: 580 patients were identified. Applying inclusion and exclusion criteria the sample was reduced to 217 (36 % women, 64 % men, median age at diagnosis of 64 y/o).Table 3. 17% of the patients developed metastases during follow-up. Fig. 6.
Radiomic features: 2,606 radiomic and delta radiomic features were extracted and 4 were selected as the best combination which maximised the confusion matrix balanced accuracy in the test set.
Logistic regressionwas the best performing classifier with accuracy, sensitivity and specificity of 80.9%, 71.4% and...
The selected combination of radiomic features predicted the risk of metastases 2 years after treatment in LARC, which is an independent predictor of overall survival and biologically aggressive tumours.
Understanding the biological behaviour of cancer enables personalised management of the patients.
Personal information and conflict of interest
P. Rodriguez Carnero; Madrid/ES - Grant Recipient at ESOR-Bracco Fellwoship M. D.-I. C. Masciocchi; Rome/IT - nothing to disclose C. Casà; Rome/IT - nothing to disclose L. Boldrini; Rome/IT - nothing to disclose J. Lenkowicz; Rome/IT - nothing to disclose B. Barbaro; Roma (RM)/IT - nothing to disclose M. A. Gambacorta; Rome/IT - nothing to disclose R. Manfredi; Rome/IT - nothing to disclose V. Valentini; Rome/IT - nothing to disclose
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