This study aims to identify risk factors-including clinical and imaging indicators such as middle rectal artery (MRA) diameter-that may be associated with lateral lymph node metastasis (LLNM) in rectal cancer located below the peritoneal reflection, and to construct a corresponding predictive model.The main questions it aims to answer are: What factors are associated with clinically suspected lateral lymph node metastasis in rectal cancer below the peritoneal reflection? Can an effective predictive model be constructed based on these factors? Participants' clinical information has been collected for statistical analysis.
Objective: This study aimed to investigate the risk factors for suspected lateral lymph node metastasis in rectal cancer below the peritoneal reflection and to construct a predictive model. Methods: This retrospective study analyzed data from 690 patients with rectal cancer below the peritoneal reflection who were treated at the First Affiliated Hospital of Fujian Medical University between January 2022 and December 2024. The original dataset was randomly divided into a training set and validation set at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed on the training set to identify the risk factors associated with clinical lateral lymph node (cLLN) metastasis and to construct a predictive model.
Study Type
OBSERVATIONAL
Enrollment
690
This is a retrospective observational study. There is no intervention assigned as part of this research. The study involves the analysis of existing clinical data from patients who were clinically suspected of lateral lymph node metastasis (LLNM) versus those who were not. Treatments received by patients (e.g., surgery, radiotherapy) were part of their routine clinical care and are not interventions administered by this study protocol.
The First Affiliated Hospital of Fujian Medical University
Fuzhou, Fujian, China
Independent Risk Factors for Clinically Suspected Lateral Lymph Node Metastasis (cLLNM)
Multivariable logistic regression analysis incorporating preoperative clinical and imaging variables to identify independent risk factors associated with clinically suspected lateral lymph node metastasis (cLLNM). Results are presented as odds ratios with 95% confidence intervals.
Time frame: At the time of preoperative assessment (Data collected retrospectively from January 2022 to December 2024).
Discriminative Ability for Clinically Suspected Lateral Lymph Node Metastasis Prediction
Assessment of the multivariable predictive model's discriminative performance in identifying patients with clinically suspected lateral lymph node metastasis (cLLNM). The model incorporates preoperative clinical and imaging variables, and its performance is quantified using the area under the receiver operating characteristic curve.
Time frame: At the time of preoperative assessment (Data collected retrospectively from January 2022 to December 2024).
Diagnostic performance of the key predictor: middle rectal artery diameter
Sensitivity, specificity, accuracy, and optimal cutoff value (≥3.25 mm) of MRA diameter alone for identifying cLLNM.
Time frame: At the time of preoperative assessment (Data collected retrospectively from January 2022 to December 2024).
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