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Background <p>To explore the lateral mesorectum structures and develop a nomogram model for predicting the prognosis of rectal cancer (RC) patients using preoperative high-resolution magnetic resonance imaging (MRI).</p> Methods <p>Patients who underwent radical resection of RC in our hospital from January 2017 to December 2018 were retrospectively analyzed. Imaging data and postoperative 3-year prognosis data of patients were collected. The lateral mesorectum was observed, and related parameters were investigated: lateral interruption of the mesorectal fascia (LI-MRF), type of the middle rectal artery (MRA), and the maximum diameter of the MRA. The impact of lateral mesorectum parameters on prognosis was determined using Cox analysis and Kaplan–Meier (KM) survival curves. A nomogram combining lateral mesorectum parameters with clinical data was constructed and its predictive performance was validated.</p> Results <p>A total of 260 patients were included in this study. In preoperative high-resolution MRI, LI-MRF and MRA were observed bilaterally in all patients. Multivariate Cox regression analysis showed that the maximum diameter of the right MRA (<i>P</i> = 0.001) and right LI-MRF (<i>P</i> = 0.016) were predictive factors for postoperative 3-year overall survival (OS). Additionally, gender (<i>P</i> = 0.015), mrT stage (<i>P</i> = 0.025), and the maximum diameter of the right MRA (<i>P</i> = 0.002) were predictive factors for postoperative 3-year disease-free survival (DFS). The concordance indexes (C-index) of the predictive nomogram were 0.737 for OS and 0.685 for DFS.</p> Conclusion <p>Preoperative high-resolution MRI revealed that the lateral mesorectum and MRA were inherent. The right LI-MRF and the maximum diameter of the right MRA were risk factors for poor postoperative survival in RC patients.</p>

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Investigating the prognostic value of lateral mesorectum using preoperative high-resolution MRI in patients with rectal cancer

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月2日

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  • Siyuan Jiang,
  • Qiaoling Chen,
  • Shuqin Zang,
  • Haidi Lu,
  • Shiyu Ma,
  • Fangying Chen,
  • Wei Zhang,
  • Chengwei Shao,
  • Fu Shen

摘要

Background

To explore the lateral mesorectum structures and develop a nomogram model for predicting the prognosis of rectal cancer (RC) patients using preoperative high-resolution magnetic resonance imaging (MRI).

Methods

Patients who underwent radical resection of RC in our hospital from January 2017 to December 2018 were retrospectively analyzed. Imaging data and postoperative 3-year prognosis data of patients were collected. The lateral mesorectum was observed, and related parameters were investigated: lateral interruption of the mesorectal fascia (LI-MRF), type of the middle rectal artery (MRA), and the maximum diameter of the MRA. The impact of lateral mesorectum parameters on prognosis was determined using Cox analysis and Kaplan–Meier (KM) survival curves. A nomogram combining lateral mesorectum parameters with clinical data was constructed and its predictive performance was validated.

Results

A total of 260 patients were included in this study. In preoperative high-resolution MRI, LI-MRF and MRA were observed bilaterally in all patients. Multivariate Cox regression analysis showed that the maximum diameter of the right MRA (P = 0.001) and right LI-MRF (P = 0.016) were predictive factors for postoperative 3-year overall survival (OS). Additionally, gender (P = 0.015), mrT stage (P = 0.025), and the maximum diameter of the right MRA (P = 0.002) were predictive factors for postoperative 3-year disease-free survival (DFS). The concordance indexes (C-index) of the predictive nomogram were 0.737 for OS and 0.685 for DFS.

Conclusion

Preoperative high-resolution MRI revealed that the lateral mesorectum and MRA were inherent. The right LI-MRF and the maximum diameter of the right MRA were risk factors for poor postoperative survival in RC patients.