MRI for prognosis prediction of T3-stage rectal cancer based on “DISTANCE” structural report

To explore whether magnetic resonance imaging (MRI) features, when employed with the MRI structural report "DISTANCE," allow the prediction of the overall survival (OS) and progression-free survival (PFS) of patients with T3-stage rectal cancer and to provide information for improved preoperative diagnosis and prognosis evaluation of T3-stage rectal cancer. This is a retrospective analysis of 205 cases of T3-stage rectal cancer from January 2014 to January 2021. Univariate, multivariate, and LASSO Cox regression analyses were performed to identify prognostic factors, construct OS and PFS feature nomograms, evaluate the value of MRI features in predicting OS and PFS, and visualize their impact on OS and PFS using Kaplan-Meier survival curves. The circumferential resection margin (CRM), obturator lymph node (Obturator N), extramural depth (EMD), maximum short axis of lymph node (maximum short axis of N), and mrEMVI were identified as independent predictors of OS and PFS. The nomogram model predicted the AUCs of OS at 2, 3, and 5 years as 0.806, 0.775, and 0.815, respectively, and those for PFS as 0.695, 0.729, and 0.726 at 2, 3, and 5 years, respectively. The CRM, EMD, Obturator N, maximum short axis of N, and mrEMVI from the MRI structural report "DISTANCE" should be employed for the prognosis prediction of T3-stage rectal cancer.