Inferior Mesenteric Artery Chemoembolization and Chemotherapy for Advanced Rectal Cancer: Report of a Clinical Case

Abstract Objective This study aimed to explore the pathological characteristics of lymph nodes around inferior mesenteric artery in rectal cancer and its risk factors and its impact on tumor staging. Methods 485 rectal cancer patients underwent proctectomy surgery were collected in this study. Clinical features of patients, including gender, age, BMI, tumor size, pathological type, differentiation, nerve invasion, lymph nodes, tumor marker, and pathological examinations, were analyzed. Results A total of 485 cases were included in this study. There were 29 cases with IMA-LN metastasis; the metastasis rate was 5.98% (29/485). Positive IMA-LNs were associated with distance from anal verge, CEA, pathological type, differentiation, nerve invasion, T stage, and N stage. Multivariate analysis showed that distance from anal verge, CEA level, differentiation, and T stage were independent risk factors for positive IMA-LNs. Conclusion Distance from anal verge, CEA level, differentiation, and T stage were independent risk factors for positive IMA-LNs. No skip metastasis occurred in IMA-LNs. We should choose the appropriate surgical methods to achieve better oncological results and reduce the incidence of postoperative complications.

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Relationship between inferior mesenteric artery diameter and rectal cancer

Archives of Medical Science ◽

10.5114/aoms/112531 ◽

2021 ◽

Author(s):

Feng Chi ◽

Shenkang Zhou ◽

Tienan Bi ◽

Wenjun Zhao ◽

Xiang Wang

Keyword(s):

Rectal Cancer ◽

Cancer Patients ◽

Mesenteric Artery ◽

Inferior Mesenteric Artery ◽

Stage Iv ◽

Tnm Stage ◽

Control Group ◽

Inferior Mesenteric Vein ◽

Computed Tomography Images ◽

N Stage

IntroductionDilated inferior mesenteric vein has been reported in rectal cancer patients. However, no study has yet reported inferior mesenteric artery (IMA) enlargement in rectal cancer. We aimed to assess the relationship between the IMA diameter and rectal cancer.Material and methodsPatients diagnosed with rectal cancer and a control group of 42 patients in our hospital from July 2017 to June 2019 were evaluated. The IMA diameter was independently measured by two observers on axial computed tomography images.ResultsThe mean IMA diameter was wider in rectal cancer patients (2.49±0.53 mm) than in the control group (2.20±0.47 mm, p<0.001). The IMA diameter of patients with stage I, stage II, stage III, and stage IV cancers was 2.24±0.36 mm, 2.45±0.39 mm, 2.80±0.55 mm, and 2.85±0.51 mm, respectively (p<0.001). The IMA diameter correlated positively and moderately with TNM stage (r=0.519, p<0.001). The IMA diameter of patients with T1, T2, T3, and T4 tumors was 2.18±0.31 mm, 2.39±0.50 mm, 2.55±0.48 mm, and 2.73±0.51 mm, respectively (p<0.001). The IMA diameter also correlated positively and moderately with T stage (r=0.457, p<0.001). The IMA diameter of patients with N0, N1, and N2 tumors was 2.37±0.39 mm, 2.83±0.60 mm, and 2.71±0.40 mm, respectively (p<0.001); however, the IMA diameter did not correlate with N stage (r=0.166, p=0.077). Patients with M1 tumors had a wider IMA diameter than patients with M0 tumors (p=0.011).ConclusionsThe IMA in rectal cancer patients enlarges as the TNM stage gets higher. The IMA diameter can be accepted as a possibly important marker for the staging of rectal cancer.

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