Background::Pre-operative assessment with high-resolution magnetic resonance imaging (MRI) is useful for assessing the risk of local recurrence (LR) and survival in rectal cancer. However, few studies have explored the clinical importance of the morphology of the anterior mesorectum, especially in patients with anterior cancer. Hence, the study aimed to investigate the impact of the morphology of the anterior mesorectum on LR in patients with primary rectal cancer.Methods::A retrospective study was performed on 176 patients who underwent neoadjuvant treatment and curative-intent surgery. Patients were divided into two groups according to the morphology of the anterior mesorectum on sagittal MRI: (1) linear type: the anterior mesorectum was thin and linear; and (2) triangular type: the anterior mesorectum was thick and had a unique triangular shape. Clinicopathological and LR data were compared between patients with linear type anterior mesorectal morphology and patients with triangular type anterior mesorectal morphology.Results::Morphometric analysis showed that 90 (51.1%) patients had linear type anterior mesorectal morphology, while 86 (48.9%) had triangular type anterior mesorectal morphology. Compared to triangular type anterior mesorectal morphology, linear type anterior mesorectal morphology was more common in females and was associated with a higher risk of circumferential resection margin involvement measured by MRI (35.6% [32/90] vs. 16.3% [14/86], P = 0.004) and a higher 5-year LR rate (12.2% vs. 3.5%, P = 0.030). In addition, the combination of linear type anterior mesorectal morphology and anterior tumors was confirmed as an independent risk factor for LR (odds ratio = 4.283, P = 0.014). Conclusions::The classification established in this study was a simple way to describe morphological characteristics of the anterior mesorectum. The combination of linear type anterior mesorectal morphology and anterior tumors was an independent risk factor for LR and may act as a tool to assist with LR risk stratification and treatment selection.

Local recurrence;Magnetic resonance imaging;Morphology of the anterior mesorectum;Rectal cancer

Wang Xiaojie;Zheng Zhifang;Chen Min;Lin Jing;Lu Xingrong;Huang Ying;Huang Shenghui;Chi Pan

Department of Colorectal Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian 350001, China;Department of Gynaecology and Obstetrics, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian 350001, China;Integrated Information Section, Fujian Children’s Hospital, Fuzhou, Fujian 350001, China

中华医学杂志（英文版）

[1]Wang Xiaojie;Zheng Zhifang;Chen Min;Lin Jing;Lu Xingrong;Huang Ying;Huang Shenghui;Chi Pan-.Morphology of the anterior mesorectum: a new predictor for local recurrence in patients with rectal cancer)[J].中华医学杂志（英文版）,2022(20):2453-2460

mesorectum,Clinicopathological

Morphology,anterior,new,predictor,local,recurrence,patients,cancer,Background,Pre,operative,assessment,resolution,magnetic,resonance,imaging,useful,assessing,risk,LR,survival,However,few,studies,have,explored,clinical,importance,morphology,especially,Hence,study,aimed,investigate,impact,primary,Methods,retrospective,was,performed,who,underwent,neoadjuvant,treatment,curative,intent,surgery,Patients,were,divided,into,two,groups,according,sagittal,linear,type,thin,triangular,thick,had,unique,shape,data,compared,between,mesorectal,Results,Morphometric,analysis,showed,that,while,Compared,more,common,females,associated,higher,circumferential,resection,margin,involvement,measured,by,year,rate,In,addition,combination,tumors,confirmed,independent,odds,ratio,Conclusions,classification,established,this,simple,way,describe,morphological,characteristics,may,tool,assist,stratification,selection,Local,Magnetic,Rectal

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