610P - Utility of magnetic resonance imaging following long-course pre-operative chemo-radiotherapy for locally advanced rectal cancer

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Cytotoxic agents
Staging procedures (clinical staging)
Surgical oncology
Colon and Rectal Cancer
Basic Principles in the Management and Treatment (of cancer)
Biological therapy
Radiation oncology
Presenter David Lucey
Authors D.J. Lucey1, A. Murphy2, V. Curran3, M. McCourt4, E. Andrews4, M. O'Riordain3, D.G. Power5, S. O'Reilly6, P.J. Kelly4
  • 1Radiotherapy Department, Cork University Hospital, Cork/IE
  • 2Medical Oncology Department, Cork University Hospital, Cork/IE
  • 3Surgery, Mercy University Hospital, Cork/IE
  • 4Surgery, Cork University Hospital, Cork/IE
  • 5Medical Oncology, Cork University Hospital, Cork/IE
  • 6Medical Oncology, Cork University Hospital, IE- - Cork/IE



Neoadjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer is associated with improved local control and results in tumour down-staging. The purpose of this study was to assess whether MRI performed following chemoradiotherapy alters surgical management.


All patients with locally advanced (cT3-4 or cN+ by endorectal ultrasound, computed tomography, or magnetic resonance imaging) rectal adenocarcinoma diagnosed in 2010 and 2011 at Cork University Hospital/Mercy University Hospital and treated with long course preoperative CRT followed by radical resection were identified and their records were retrospectively reviewed from prospectively maintained institutional databases . Only patients who had MRI pre- and post-neoadjuvant therapy were eligible for inclusion.


Thirty patients had MRI pre- and post long course chemoradiotherapy. Male: Female was 3:2, the median age was 60 (range 36-77). Abdominoperineal resection was performed in 12 of these patients, and anterior resection in 18 patients. The median radiation dose was 50.4 Gy with concurrent 5FU-based chemotherapy. Median time from completion of CRT to post-treatment MRI was 30 days, and the median time to surgery from the 2nd MRI was 23 days. Only 1 of the 30 patients (3.3%) showed disease progression on the repeat scan and R0 resection was achieved in this case. Three patients (10%) achieved pathologic complete remission and none of these had a radiographic CR on post-treatment MRI. Two patients (6.6%) had positive circumferential resection margins and neither was predicted by post-treatment MRI.


MRI following neoadjuvant therapy prior to surgical resection did not alter clinical management in this small retrospective series. The utility of post CRT MRI prior to definitive resection is unclear and international guidelines do not recommend this approach.


All authors have declared no conflicts of interest.