Preoperative Magnetic Resonance Imaging can predict good outcomes for rectal cancer patients treated with surgery alone

The present study examined the survival rate of rectal cancer (RC) patients treated with surgery alone, based on preoperative Magnetic Resonance Imaging (MRI) staging predictive of a good prognosis.

RC is staged according to how far the cancer has spread through the walls of the rectum (the final section of the large intestine) and to other parts of the body. This staging process allows the doctor to determine the best treatment strategy. RC staging relies on the results of the physical exam, biopsy and imaging tests (X-rays, ultrasound, Computed Tomography or CT). MRI is a test that uses magnetic waves to create images of tissues, organs and other structures of the body. These pictures can be viewed and stored on a computer. Unlike some other imaging methods, with MRI scan there is no exposure to X-rays or any other damaging forms of radiation. MRI also provides more accurate, high resolution, images of soft tissues (such as the intestine and pelvic organs).

The present study included 122 RC patients who were defined as “good prognosis” based on pre-operative MRI scans. All patients were treated with surgery alone. Parameters measured during approximately 7 years of follow-up were overall survival (the percentage of patients who have survived for a defined period of time), disease-free survival (the percentage of living patients without signs of the disease) and local recurrence rate (the percentage of living patients who experience return of the cancer). Overall survival and disease-free survival 5 years after surgery were 68.2% and 84.7% respectively. A local recurrence developed in 3.3% of the patients. 

In summary, this article shows that MRI can accurately stage RC and can select the patients who are likely to have good outcomes with surgery alone, thus avoiding the risk of further complications due to radiation and chemotherapy.