For a study, the researchers sought to show how MRI-detected Extramural Venous Invasion (mrEMVI) can be used as an independent predictor of poor oncologic outcomes in patients following neoadjuvant therapy followed by total mesorectal excision. The PRISMA guidelines were used to create the review. The following electronic databases were searched from January 2002 to January 2020: CENTRAL, Ovid MEDLINE, PubMed, and Ovid Embase. DFS and overall survival (OS) were the primary outcomes. Positive resection margin and synchronous metastases were 2 different outcomes of interest. For data synthesis, 17 trials with a total of 3,821 patients were included. The pooled hazard ratio (HR) estimate for DFS for mrEMVI preneoadjuvant therapy was 2.30 (95% CI 1.54–3.44) for more remarkable recurrence in mrEMVI-positive individuals. With a pooled HR of 1.68 (95% CI 1.27–2.22), mrEMVI-positive patients were observed to have a worse OS. For mrEMVI-positivity, the pooled risk ratio for synchronous metastasis was 4.11 (95% CI 2.80–6.02). Positive status was associated with a lower DFS for the post neoadjuvant therapy EMVI (ymrEMVI), with a pooled HR of 2.04 (95% CI 1.55–2.69). For ymrEMVI-positive individuals, the risk ratio of having a positive resection margin status was 2.95 (95% CI 1.75–4.98). According to the study, the oncologic results for mrEMVI-positive individuals were significantly poorer both before and after neoadjuvant treatment. Therefore, MRI-detected EMVI should be reported consistently in rectal cancer staging, as it may help guide the need for different systemic therapy.
