Current Colorectal Cancer Reports

, Volume 12, Issue 3, pp 130–140 | Cite as

Extramural Venous Invasion (EMVI) and Tumour Regression Grading (TRG) as Potential Prognostic Factors for Risk Stratification and Treatment Decision in Rectal Cancer

  • Francesco SclafaniEmail author
  • Gina Brown
Personalized Medicine in Colorectal Cancer (D Cunningham and EC Smyth, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Personalized Medicine in Colorectal Cancer


Routine implementation of risk-adapted therapeutic strategies is one of the highest priorities in the management of locally advanced rectal cancer (LARC). Refinement of risk stratification and better treatment selection have the potential to minimise undesirable treatment-related side effects and improve oncological outcome of patients with this disease. Pathological extramural venous invasion (pEMVI) and tumour regression grade (pTRG) within the resection specimens have been historically regarded as prognostic factors for LARC. More recently, studies have increasingly reported suggesting that these parameters can be detected by high-resolution magnetic resonance imaging (i.e. mrEMVI and mrTRG) significantly widening the opportunities to assess individual patient risk and adapt the treatment plan accordingly. In this article, we review the available evidence on the prognostic role of pEMVI, pTRG, mrEMVI and mrTRG in LARC. Moreover, we discuss how using these prognostic factors in clinical practice may potentially promote the implementation of selected therapeutic strategies in this setting.


Rectal cancer Extramural venous invasion pEMVI mrEMVI Tumour regression grading pTRG mrTRG 



Dr. Francesco Sclafani and Dr. Gina Brown are supported by the NIHR Biomedical Research Centre based at The Royal Marsden NHS Foundation Trust and at The Institute of Cancer Research. Dr. Francesco Sclafani is also supported by the Peter Stebbings Memorial Charity.

Compliance with Ethical Standards

Conflict of Interest

Francesco Sclafani and Gina Brown declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.Department of Medicine, The Royal Marsden NHS Foundation TrustLondon and SurreySuttonUK
  2. 2.Department of Radiology, The Royal Marsden NHS Foundation TrustLondon and SurreyLondonUK

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