Is extramural venous invasion (EMVI) alone an indication to treat rectal cancer patients with total neoadjuvant therapy as opposed to neoadjuvant chemoradiation therapy or short course radiation therapy alone?   

EMVI detected on a staging pelvic MRI for rectal cancer has been shown to be a poor prognostic factor with an increased risk for distant metastases (Siddiqui et al., PMID 28449006). EMVI was also independently associated with a positive circumferential resection margin in low rectal tumors based on ...