Predicting distant metastasis and chemotherapy benefit in locally advanced rectal cancer

Zhenyu Liu, Xiaochun Meng, Hongmei Zhang, Zhenhui Li, Jiangang Liu, Kai Sun, Yankai Meng, Weixing Dai, Peiyi Xie, Yingying Ding, Meiyun Wang (), Guoxiang Cai () and Jie Tian ()
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Zhenyu Liu: Chinese Academy of Sciences
Xiaochun Meng: The Sixth Affiliated Hospital of Sun Yat-sen University
Hongmei Zhang: Chinese Academy of Medical Sciences and Peking Union Medical College
Zhenhui Li: The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital)
Jiangang Liu: Beihang University
Kai Sun: Chinese Academy of Sciences
Yankai Meng: Chinese Academy of Medical Sciences and Peking Union Medical College
Weixing Dai: Fudan University Shanghai Cancer Center
Peiyi Xie: The Sixth Affiliated Hospital of Sun Yat-sen University
Yingying Ding: The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital)
Meiyun Wang: Henan Provincial People’s Hospital & the People’s Hospital of Zhengzhou University
Guoxiang Cai: Fudan University Shanghai Cancer Center
Jie Tian: Chinese Academy of Sciences

Nature Communications, 2020, vol. 11, issue 1, 1-11

Abstract: Abstract Distant metastasis (DM) is the main cause of treatment failure in locally advanced rectal cancer. Adjuvant chemotherapy is usually used for distant control. However, not all patients can benefit from adjuvant chemotherapy, and particularly, some patients may even get worse outcomes after the treatment. We develop and validate an MRI-based radiomic signature (RS) for prediction of DM within a multicenter dataset. The RS is proved to be an independent prognostic factor as it not only demonstrates good accuracy for discriminating patients into high and low risk of DM in all the four cohorts, but also outperforms clinical models. Within the stratified analysis, good chemotherapy efficacy is observed for patients with pN2 disease and low RS, whereas poor chemotherapy efficacy is detected in patients with pT1–2 or pN0 disease and high RS. The RS may help individualized treatment planning to select patients who may benefit from adjuvant chemotherapy for distant control.

Date: 2020
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DOI: 10.1038/s41467-020-18162-9

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