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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Surgical Oncology
Volume 14 - 2024 |
doi: 10.3389/fonc.2024.1356022
This article is part of the Research Topic Colorectal Cancer Awareness Month 2023: Diagnosis, Clinical Course, and Surgical Management of Metastatic Colorectal Cancer View all 11 articles
The role of superior hemorrhoidal vein (SHV) ectasia in the preoperative staging of rectal cancer
Provisionally accepted
Nicola M. Lucarelli
1
Alessandra Mirabile
2
Nicola Maggialetti
1
Chiara Morelli
1*
Roberto Calbi
3
Simona Bartoli
1
Pasquale Avella
4*
Domenico Saccente
1
Sara Greco
1
Antonio A. Ianora Stabile
1- 1 Section of Diagnostic Imaging, Department of Interdisciplinary Medicine, School of Medicine, University of Bari Aldo Moro, Bari, Italy
- 2 U.O.C. Radiodiagnostics Operational Unit, San Giacomo Hospital (Monopoli), Monopoli, Italy
- 3 Department of Radiology, F. Miulli Regional General Hospital, Acquaviva, Italy
- 4 University of Naples Federico II, Naples, Italy
The prognosis of colorectal cancer has continuously improved in recent years thanks to continuous progress in both the therapeutic and diagnostic fields. The specific objective of this study is to contribute to the diagnostic field through the evaluation of the correlation between superior hemorrhoidal vein (SHV) ectasia detected on CT and TNM examination and MRF invasion in the preoperative staging of rectal cancer.Between January 2018 and April 2022, 46 patients with histopathological diagnosis of rectal cancer were retrospectively enrolled and the diameter of the SHV was evaluated by CT examination.The cut-off value for SHV diameter used is 3.7 mm. The diameter was measured at the level of S2 during portal venous phase after 4x image zoom to reduce the interobserver variability. The parameters evaluated were tumour location, detection of MRF infiltration (defined as the distance < 1 mm between the tumour margins and the fascia), SHV diameter, detection of mesorectal perilesional lymph nodes, detection of metastasis.67.39% (31/46) of patients had SHV ectasia. All patients with MRF infiltration (4/46, 7.14%) presented SHV ectasia (average diameter 4.4 mm) and SHV was significantly related with the development of liver metastases at the moment of primary staging and during follow-up.SHV ectasia may be related to metastasis and MRF involvement therefore it could become a tool for preoperative staging of rectal cancer.
Keywords: Computed Tomography, CT, rectal cancer, superior hemorrhoidal vein, liver metastasis. Abbreviations EMVI: Extramural vascular invasion, MRF: Mesorectal fascia, MRI: magnetic resonance imaging, CT: Computed Tomography, SHV: Superior hemorrhoidal vein, LVI: Lymph-vascular invasion, SR: structured reporting
Received: 14 Dec 2023; Accepted: 09 Jul 2024.
Copyright: © 2024 Lucarelli, Mirabile, Maggialetti, Morelli, Calbi, Bartoli, Avella, Saccente, Greco and Ianora Stabile. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chiara Morelli, Section of Diagnostic Imaging, Department of Interdisciplinary Medicine, School of Medicine, University of Bari Aldo Moro, Bari, Italy
Pasquale Avella, University of Naples Federico II, Naples, Italy
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