Molecular pAthologic and MRI investigation of the prognostic and predictive importance of extramural VEnous invasion in rectaL Cancer

Very little is known about the long-term outcomes and response to CRT on MRI detected ex-tramural venous invasion (mrEMVI). Although mrEMVI is accepted as a marker of poor prog-nosis, whether it has a predictive value and should be specifically treated is not known.

Molecular and genetic profiling provides us with an opportunity to understand the underlying mechanisms which govern clinical behaviour in rectal cancer. It offers the ability to compare the molecular profiles of different subtypes of rectal cancer such as mrEMVI-positive and – negative tumours and whether any changes are observed following CRT. This can then be cor-related with clinical behaviour over the medium and long-term with regards to local recur-rence, distant metastases and overall survival.

MARVEL is a multicentre, observational study that collects data and tissue from patients with rectal adenocarcinoma who have had pre-operative chemoradiotherapy.

Primary endpoint: Difference in Relapse Free Survival (RFS) between EMVI positive and negative (on pre-treatment MRI) patients, measured from date of surgery.

The MARVEL trial is now closed to recruitment.

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