Beyond the tumor region:Peritumoral radiomics enhances prognostic accuracy in locally advanced rectal cancer

作     者：Zhi-Ying Liang Mao-Li Yu Hui Yang Hao-Jiang Li Hui Xie Chun-Yan Cui Wei-Jing Zhang Chao Luo Pei-Qiang Cai Xiao-Feng Lin Kun-Feng Liu Lang Xiong Li-Zhi Liu Bi-Yun Chen 

作者机构：Department of RadiologyState Key Laboratory of Oncology in South ChinaGuangdong Provincial Clinical Research Center for CancerSun Yat-sen University Cancer CenterGuangzhou 510060Guangdong ProvinceChina Department of RadiologyWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina West China School of MedicineSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of Medical ImagingFirst Affiliated Hospital of Gannan Medical UniversityGanzhou 341000Jiangxi ProvinceChina 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志(英文))

年 卷 期：2025年第31卷第8期

页      面：49-65页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Department of Cancer Prevention 

主　　题：Rectal cancer Peritumoral radiomics Intratumoral radiomics Prognosis analysis Variable importance analysis Tumor microenvironment 

摘      要：BACKGROUND The peritumoral region possesses attributes that promote cancer growth and ***,the potential prognostic biomarkers in this region remain relatively underexplored in *** To investigate the prognostic value and importance of peritumoral radiomics in locally advanced rectal cancer(LARC).METHODS This retrospective study included 409 patients with biopsy-confirmed LARC treated with neoadjuvant chemoradiotherapy and *** were divided into training(n=273)and validation(n=136)*** on intratumoral and peritumoral radiomic features extracted from pretreatment axial high-resolution small-field-of-view T2-weighted images,multivariate Cox models for progression-free survival(PFS)prediction were developed with or without clinicoradiological features and evaluated with Harrell’s concordance index(C-index),calibration curve,and decision curve *** stratification,Kaplan-Meier analysis,and permutation feature importance analysis were *** The comprehensive integrated clinical-radiological-omics model(ModelICRO)integrating seven peritumoral,three intratumoral,and four clinicoradiological features achieved the highest C-indices(0.836 and 0.801 in the training and validation sets,respectively).This model showed robust calibration and better clinical net benefits,effectively distinguished high-risk from low-risk patients(PFS:97.2%vs 67.6%and 95.4%vs 64.8%in the training and validation sets,respectively;both P0.001).Three most influential predictors in the comprehensive ModelICRO were,in order,a peritumoral,an intratumoral,and a clinicoradiological ***,the peritumoral model outperformed the intratumoral model(C-index:0.754 vs 0.670;P=0.015);peritumoral features significantly enhanced the performance of models based on clinicoradiological or intratumoral features or their *** Peritumoral radiomics holds greater prognostic value than intratumoral radiomics for predicting PFS in L