Extramural Venous Invasion (EMVI) and Tumour Regression Grading (TRG) as Potential Prognostic Factors for Risk Stratification and Treatment Decision in Rectal 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. [ABSTRACT FROM AUTHOR]