{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,5]],"date-time":"2025-05-05T23:51:28Z","timestamp":1746489088760},"reference-count":18,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2013,11,5]],"date-time":"2013-11-05T00:00:00Z","timestamp":1383609600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Extramural vascular invasion (<jats:styled-content style=\"fixed-case\">EMVI<\/jats:styled-content>) has been proposed as an adverse prognostic indicator in colorectal cancer, although its use remains both variable and controversial. This study aimed to determine the survival effect of <jats:styled-content style=\"fixed-case\">EMVI<\/jats:styled-content> in T4 rectal cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients undergoing surgery with curative intent for primary T4 rectal cancer between 1971 and 2011 were included from two prospectively collected rectal cancer databases. The main end\u2010point was 3\u2010year survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 1142 patients undergoing resection of rectal cancer during the study period, 126 (11.0%) had T4 rectal cancer and were included in the study group. Sphincter preservation was performed in 61 (48%) and a pathologically negative resection margin (R0) was achieved in 104 patients (82.5%). <jats:styled-content style=\"fixed-case\">EMVI<\/jats:styled-content> was present in 51 patients (40.5%) and was an independent predictor of positive lymph node status (adjusted odds ratio 2.66, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.013). Considering all patients, <jats:styled-content style=\"fixed-case\">EMVI<\/jats:styled-content> was associated with reduced overall survival (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.007) and disease\u2010free survival (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002), but not local recurrence\u2010free survival (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.198). In only those undergoing R0 resection, <jats:styled-content style=\"fixed-case\">EMVI<\/jats:styled-content> predicted reduced disease\u2010free survival with positive nodal status (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.021); it did not predict survival with negative nodal status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Overall, <jats:styled-content style=\"fixed-case\">EMVI<\/jats:styled-content> was a strong prognostic marker of survival. However, after complete surgical resection in patients with node\u2010negative disease, <jats:styled-content style=\"fixed-case\">EMVI<\/jats:styled-content> did not predict local recurrence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12421","type":"journal-article","created":{"date-parts":[[2013,10,8]],"date-time":"2013-10-08T14:38:43Z","timestamp":1381243123000},"update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Prognostic significance of extramural vascular invasion in <scp>T<\/scp>4 rectal cancer"],"prefix":"10.1111","volume":"15","author":[{"given":"A.","family":"Bhangu","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery the Royal Marsden Hospital London UK"},{"name":"Division of Surgery Imperial College Chelsea and Westminster Campus London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. E. F.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery the Royal Marsden Hospital London UK"},{"name":"Division of Surgery Imperial College Chelsea and Westminster Campus London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Slesser","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery the Royal Marsden Hospital London UK"},{"name":"Division of Surgery Imperial College Chelsea and Westminster Campus London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"Northover","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery St Mark's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"O.","family":"Faiz","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery St Mark's Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Tekkis","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery the Royal Marsden Hospital London UK"},{"name":"Division of Surgery Imperial College Chelsea and Westminster Campus London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,11,5]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(11)70097-3"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2012.03005.x"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.5091"},{"key":"e_1_2_10_5_1","volume-title":"Dataset for Colorectal Cnacer","author":"The Royal College of Pathologists","year":"2007"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.26310"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2008.01553.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.5345"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-008-0594-x"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31820b8d52"},{"key":"e_1_2_10_12_1","first-page":"CD004078","article-title":"Postoperative adjuvant chemotherapy in rectal cancer operated for cure","volume":"3","author":"Petersen SH","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.11.0445"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.55.1.17"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-007-9021-6"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2009.03397.x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.2006.02543.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8881"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181c70465"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcodi.12421","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.12421","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T17:55:38Z","timestamp":1696269338000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.12421"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,11]]},"references-count":18,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1111\/codi.12421"],"URL":"https:\/\/doi.org\/10.1111\/codi.12421","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,11]]},"assertion":[{"value":"2013-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-03-29","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-11-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}