A new study suggests that MRI can help rectal cancer patients avoid invasive surgeries by predicting outcomes after chemotherapy and radiation, pioneering a potential shift in cancer treatment.
A new study shows that magnetic resonance imaging (MRI) can help many rectal cancer patients avoid invasive surgeries, potentially sparing them from lifelong side effects. The research, spearheaded by Arun Krishnaraj and his team at UVA Cancer Center, suggests that MRI can effectively predict patient outcomes and the risk of tumor recurrence or metastasis following initial treatments of chemotherapy and radiation.
“No one wants to get surgery if they can avoid it. Now we have a powerful tool to help patients and their doctors predict who would benefit from surgery after initial chemotherapy and radiation and who can likely avoid surgery,” Krishnaraj, director of UVA Health’s Division of Body Imaging, said in a news release.
This breakthrough could simplify decision-making processes for doctors and provide comfort to patients, potentially reducing the need for invasive procedures like total mesorectal excision, which often lead to drastic side effects, such as permanent colostomy bags and sexual dysfunction.
Colorectal cancer is an ever-growing concern, particularly among younger adults under 50, even as it appears to decrease in the older population. Statistics from the American Cancer Society estimate that the disease will impact approximately 1 in 23 men and 1 in 25 women.
Addressing the intricacies of care for rectal cancer, the research team aimed to validate MRI’s predictive power in determining who can safely adopt a “watch-and-wait” approach after initial treatments. During this period, doctors closely monitor patients for any cancer recurrence or spread, yet patients are often left anxious about their future prospects.
Analyzing data from the Organ Preservation in Rectal Adenocarcinoma (OPRA) trial, the researchers evaluated outcomes from 277 patients, with an average age of 58, whose cancer stages were determined using MRI. With a follow-up period averaging just over four years, the study confirmed that MRI serves as an effective predictive tool for these patients’ overall survival, cancer recurrence risk and bowel preservation likelihood.
“After undergoing chemotherapy and radiation for rectal cancer, patients are understandably concerned whether their cancer is gone or whether there may be some leftover disease. Using newer MRI techniques, we are now able to predict much better than in the past whether any cancer remains and, if so, whether it will come back and spread,” Krishnaraj added.
Furthermore, Krishnaraj and his colleagues believe that MRI’s accuracy could improve when combined with endoscopy data obtained post-treatment. They call for additional research to explore this combination’s potential, which they assert could lead to an even more robust predictive tool for physicians and patients.
“I am optimistic that continued advancement in MRI and other tools like endoscopy will provide better information about future outcomes,” added Krishnaraj. “Ultimately, I would love to get close to 99% predictive probability in better informing our patients about their potential risk for recurrence or spread of their cancers following treatment. We may not be there quite yet, but that is our goal.”
The full findings from this study have been published in the journal Radiology.