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Correlation and prognostic value of CT-detected extramural venous invasion and pathological lymph-vascular invasion in colon cancer

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Abstract

Purpose

To explore the association between CT-detected extramural vascular invasion (ctEMVI) and lymph-vascular invasion (LVI) in colon cancer, and analyze the prognostic value of ctEMVI in different conditions of LVI.

Methods

This single-center, retrospective study included 448 colon cancer patients from January 2015 to December 2017. Preoperative CT features and clinical and pathological data were collected. Associations between ctEMVI and LVI were tested. Univariate and multivariate logistic regression was performed. Multivariate Cox regression was performed adjusted with propensity score(PS). Kaplan–Meier method was used to compare survival differences between the ctEMVI and LVI groups. A 1:1 patient pairing was conducted using PS matching to assess the prognostic effect of ctEMVI in LVI subgroups.

Results

Among the 448 patients, there were 261 men and 187 women, with an average age of 63 ± 12 years. The coincidence rate of ctEMVI and LVI was 73.9%. The k coefficient for identifying ctEMVI was 0.84. ctEMVI and LVI were both independent risk factors for overall survival (ctEMVI: HR 2.8, 95% CI 1.5–5.5; LVI: HR 2.2, 95% CI 1.2–4.1) and metastasis-free survival (ctEMVI: HR 3.3, 95% CI 1.7–6.4; LVI: HR 2.4, 95% CI 1.3–4.5) adjusted with PS. In the LVI(+) subgroup, the prognosis of ctEMVI(+) was significantly worse than that of ctEMVI(−); in the LVI(−) subgroup, the prognosis of different ctEMVI states was similar.

Conclusion

ctEMVI is an independent prognostic risk factor and has different prognostic value in different LVI states. It is recommended to perform the evaluation in routine work, especially for patients with positive LVI.

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Abbreviations

NAT:

Neoadjuvant therapy

pMMR:

Proficient mismatch repair

LVI:

Lymph-vascular invasion

EMVI:

Extramural venous invasion

ctEMVI:

CT-detected extramural venous invasion

pEMVI:

Pathological extramural venous invasion

IMVI:

Intramural venous invasion

EMD:

Extramural tumor depth

OS:

Overall survival

MFS:

Metastasis-free survival

HR:

Hazard ratio

CI:

Confidence interval

PS:

Propensity score

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Acknowledgements

We thanked Hong Jiang for providing the follow-up support for this work.

Funding

This study was supported by National Key R&D Program of China (2019YFC0117705), National Natural Science Foundation of China (91959116, 82071881, 81971584), Capital's Funds for Health Improvement and Research (2020-1-2151), Beijing Natural Science Foundation (Z200015), Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (No.ZYLX201803), Beijing Hospitals Authority’ Ascent Plan, 2019 SKY Imaging Research Fund of the Chinese International Medical Foundation (Project No.Z-2014-07-1912).

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Author notes

  1. Zhen Guan and Xiao-Yan Zhang contributed equally to this work.

Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China

    Zhen Guan, Xiao-Yan Zhang, Xiao-Ting Li, Rui-Jia Sun, Qiao-Yuan Lu & Ying-Shi Sun

  2. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China

    Ai-Wen Wu

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Guan, Z., Zhang, XY., Li, XT. et al. Correlation and prognostic value of CT-detected extramural venous invasion and pathological lymph-vascular invasion in colon cancer. Abdom Radiol 47, 1232–1243 (2022). https://doi.org/10.1007/s00261-022-03414-7

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