Abstract
OBJECTIVE: Preoperative MRI staging offers a noninvasive approach to assess local tumor invasion and distant metastasis. Attention has been paid to investigating the impact of preoperative abdominal MRI staging on the prognosis of patients with stage II-III colon cancer. METHODS: Patients who underwent radical resection for stage II-III colon cancer at Yunnan Cancer Hospital between 2008 and 2017 were retrospectively analyzed and divided into preoperative MRI and non-MRI groups. Propensity score matching (PSM) was applied to balance patient characteristics. Overall survival (OS) and Disease-free survival (DFS) were compared using the Kaplan-Meier method and log-rank test. Additionally, Cox regression was used to evaluate the correlation between preoperative MRI and prognosis, and subgroup analyses further compared the two groups. For multivariable analysis, two models were constructed and compared. RESULTS: Among 1086 patients included, 29.28% underwent preoperative abdominal MRI. Patients who received preoperative MRI demonstrated better OS (log-rank p = 0.002), particularly those with stage III colon cancer (p < 0.05). After PSM, the MRI group exhibited significantly better 5-year OS (90.0% vs. 82.0%, P = 0.019) and a lower risk of death (HR, 1.66; 95% CI, 1.07-2.56; P = 0.024). Subgroup analysis revealed that the OS of preoperative MRI was significant in stage III patients. However, no significant difference was observed in DFS between the two groups. Furthermore, compared to the MRI group, the non-MRI group showed a statistically significant increased risk in model 1 (OR = 1.63, 95% CI: 1.08-2.44, P = 0.020) and model 2 (OR = 1.79, 95% CI: 1.17-2.73, P = 0.007) in terms of OS. CONCLUSION: Preoperative abdominal MRI significantly enhances OS in patients with stage II-III colon cancer, especially in those with stage III disease. However, the specific role of MRI in treatment planning, as well as the potential impact of different treatment approaches on outcomes, warrants further investigation into the treatment decision-making processes.