Imaging features and correlation with short-term prognosis in laparoscopic radical resection of colorectal cancer

Abstract

BACKGROUND

Colorectal cancer (CRC) is a malignant tumor with high morbidity and mortality rates worldwide. With the development of medical imaging technology, imaging features are playing an increasingly important role in the prognostic evaluation of CRC. Laparoscopic radical resection is a common surgical approach for treating CRC. However, research on the link between preoperative imaging and short-term prognosis in this context is limited. We hypothesized that specific preoperative imaging features can predict the short-term prognosis in patients undergoing laparoscopic CRC resection.

AIM

To investigate the imaging features of CRC and analyze their correlation with the short-term prognosis of laparoscopic radical resection.

METHODS

This retrospective study conducted at the Affiliated Cancer Hospital of Shandong First Medical University included 122 patients diagnosed with CRC who underwent laparoscopic radical resection between January 2021 and February 2024. All patients underwent magnetic resonance imaging (MRI) and were diagnosed with CRC through pathological examination. MRI data and prognostic indicators were collected 30 days post-surgery. Logistic regression analysis identified imaging features linked to short-term prognosis, and a receiver operating characteristic (ROC) curve was used to evaluate the predictive value.

RESULTS

Among 122 patients, 22 had irregular, low-intensity tumors with adjacent high signals. In 55, tumors were surrounded by alternating signals in the muscle layer. In 32, tumors extended through the muscular layer and blurred boundaries with perienteric adipose tissue. Tumor signals appeared in the adjacent tissues in 13 patients with blurred gaps. Logistic regression revealed differences in longitudinal tumor length, axial tumor length, volume transfer constant, plasma volume fraction, and apparent diffusion coefficient among patients with varying prognostic results. ROC analysis indicated that the areas under the curve for these parameters were 0.648, 0.927, 0.821, 0.809, and 0.831, respectively. Sensitivity values were 0.643, 0.893, 0.607, 0.714, and 0.714, and specificity 0.702, 0.904, 0.883, 0.968, and 0.894 (P < 0.05).

CONCLUSION

The imaging features of CRC correlate with the short-term prognosis following laparoscopic radical resection. These findings provide valuable insights for clinical decision-making.

Key Words: Colorectal cancer; Imaging features; Laparoscopic radical resection; Short-term prognosis; Tumor signal; Prognostic indicators

Core Tip: Colorectal cancer (CRC) is recognized as a highly prevalent and deadly malignant tumor that affects many patients globally. This study analyzed preoperative magnetic resonance imaging (MRI) data and 30-day postoperative prognostic indicators by using logistic regression and receiver operating characteristic curves. The key findings highlight the role of MRI in predicting short-term outcomes after laparoscopic radical resection, emphasizing the importance of imaging-derived indicators. These insights enhance the prognostic accuracy and guide tailored treatment approaches for patients with CRC.

INTRODUCTION

Colorectal cancer (CRC), a prevalent malignant tumor of the digestive system, often initially manifests as subtle changes in bowel habits, diarrhea, and hematochezia. As the condition progresses, patients may exhibit systemic symptoms, including weight loss and anemia. Poor lifestyle, genetic predisposition, and intestinal inflammation contribute to its development[1,2]. With recent developments and the popularization of laparoscopic technology, laparoscopic radical resection has become a common surgical method for treatment[3,4]. However, the prognoses of these patients vary significantly. Therefore, it is important to identify a reliable method to predict the short-term prognosis of patients. Magnetic resonance imaging (MRI) has a high resolution and lesion detection rate. Through MRI examination, the relationship between the tumor and colorectal wall can be accurately displayed, as well as the speed and process of contrast agent clearance from the lesion. This capability allows for direct assessment of the microcirculation of the lesion, which is highly valuable in the prognostic evaluation of CRC[5]. This study analyzed the imaging features of CRC and explored their correlation with the short-term prognosis of laparoscopic radical resection to provide a basis for clinical decision-making.

MATERIALS AND METHODS

Patient characteristics

Between January 2021 and February 2024, 122 patients diagnosed with CRC who underwent radical laparoscopic surgery at the Affiliated Cancer Hospital of Shandong First Medical University were included in this study. Postoperative imaging data, before surgery, and prognostic indicators 30 days after surgery were systematically collected. Based on their postoperative outcomes, patients were categorized into a favorable prognosis group (n = 94) and a poor prognosis group (n = 28). The favorable prognosis group comprised 55 males and 39 females, with ages ranging from 34 to 77 years and an average age of 57.60 ± 8.56 years. The poor prognosis group included 18 males and 10 females, aged between 45 and 71 years, with an average age of 57.61 ± 8.04 years. All patients presented with varying degrees of symptoms, such as hematochezia, abdominal discomfort, dyspepsia, and abnormal bowel movements. The distribution of tumor types was as follows: 38 cases of rectal cancer, 36 cases of sigmoid colon cancer, 20 cases of transverse colon cancer, 15 cases of rectosigmoid junction cancer, nine cases of descending colon cancer, and four cases of ileocecal cancer.

Eligibility for the study was determined using the following criteria: First, participants had not undergone radiotherapy, chemotherapy, or any other form of treatment before surgical intervention. Second, the inclusion criteria were limited to those patients who had received a pathological diagnosis of CRC. Third, all the patients in this study underwent laparoscopic radical resection at our facility. Finally, only those individuals with complete and available medical records were included. Exclusion from the study was based on specific conditions: Individuals who were currently lactating or pregnant were excluded. Additionally, patients with documented abnormalities in vital organ function, such as the heart, liver, or kidneys, were excluded from the study. The study was reviewed and approved by the Institutional Review Board of the Affiliated Cancer Hospital of Shandong First Medical University (Approval No.2024007003).

MRI examination

A 1.5T MRI system equipped with an 8-channel phased-array body coil was used in this study. The participants were placed in the supine position with their feet forward during the procedure. Initial tumor localization was performed, followed by sequential imaging in both the cross-sectional and coronal planes with the tumor as the focal point. The technical parameters for the scans were as follows: 5 mm slice thickness with a corresponding 5 mm gap. For T1-weighted imaging, the parameters included a repetition time (TR) of 620 millisecond and an echo time (TE) of 6 millisecond within a scanning field of view (FOV) of 32 cm × 32 cm. Axial T2-weighted imaging (T2WI) without fat suppression featured a TR of 2600 millisecond and (TE) of 80 millisecond, with a FOV of 32 cm × 32 cm. Sagittal T2WI without fat suppression had a TR of 3400 millisecond and a TE of 120 millisecond within a FOV of 26 cm × 26 cm. Finally, coronal and oblique axial T2WI without fat suppression were acquired with a TR of 3400 millisecond and TE of 120 millisecond, with a FOV of 20 cm × 20 cm.

Imaging features

The axial tumor length (ATL), longitudinal tumor length (LTL), ATL/LTL ratio, apparent diffusion coefficient (ADC), lymph node metastasis, and tumor circumferential resection margin (CRM) were measured and recorded. Lymph nodes with short diameters greater than 8 mm or less than 8 mm but with irregular morphology, rough edges, uneven signals, and high DWI signals were defined as positive for lymph node metastasis (+); otherwise, lymph node metastasis was defined as negative (-). When the distance between the primary tumor and malignant structures, such as metastatic lymph nodes in the mesorectum, cancer nodules, extra-rectal vascular invasion, mesorectal fascia, and adjacent structures, was less than 1 mm, the tumor was CRM-positive (+). Otherwise, it was CRM negative (-). Quantitative parameters such as the rate constant (K_ep), volume transfer constant (K^trans), volume of the extravascular extracellular space (V_e), and plasma volume fraction (V_p) were measured using the software. Relevant indicators were measured and recorded by two experienced imaging specialists. The final result is the average of two measurements. The intraclass correlation coefficient (ICC) was calculated to evaluate the reliability of the imaging results obtained by the two specialists (ICC < 0.4 is poor, 0.4-0.75 is fair, > 0.75 is good)[6].

Prognostic indicators of patients

Prognostic indicators included perioperative indicators (operation time, perioperative bleeding, first exhaust time, first defecation time, eating recovery time, and hospital stay) and postoperative complications (incision infection, anastomotic fistula, anastomotic bleeding, ileus, abdominal infection, and pulmonary infection).

Statistical analysis

Statistical analyses were performed using SPSS version 23.0. Categorical data are presented as the frequency of occurrence (n) and percentage (%). The χ² test was used to examine the differences in proportions between the groups. Additionally, we performed a t-test to evaluate and compare the quantitative data between the two groups. To assess the predictive value of the imaging characteristics for the outcomes of patients diagnosed with CRC, we performed receiver operating characteristic (ROC) curve analysis. Statistical significance was set at P < 0.05.

RESULTS

Analysis of MRI imaging features

Among 122 cases of CRC, 22 showed low signal intensity and irregularly shaped tumor lesions, whereas the adjacent mucosa and submucosa had relatively high signal intensities. In 55 cases, alternating low and high signals of the muscle layer surrounded the tumor lesions, with the low signal of the muscle layer appearing as a complete continuous ring (of these, 46 cases of tumor lesions had rough edges or uneven signals, and nine cases of lymph nodes on MRI images showed obvious high signals). In 32 cases, the tumor signal passed through the muscular layer, and the boundary between the muscular layer and the perienteric adipose tissue was blurred (among these cases, 7 showed a high signal in the perienteric adipose tissue, which was mostly tortuous or nodular). Tumor signals were found in 13 adjacent tissues and organs, and the fat space between the adjacent tissues and organs was blurred (among these cases, three lymph nodes showed obvious high signals on MRI). Figure 1 shows the MRI findings of the patient diagnosed with rectal cancer.

Figure 1 Images of patients with rectal cancer. A: Sagittal view showing intestinal wall thickening located approximately 7.0 cm from the anal edge, with a lesion length of approximately 3.6 cm. There is local posterior margin breakthrough of the outer membrane layer into the periintestinal fascia; B: Posterior wall of the rectum demonstrating thickening and uneven enhancement; C: T2-weighted imaging sequence revealing significant uneven thickening of the posterior rectal wall, penetrating the adventitia and invading adjacent periintestinal fascia; D: DWI sequence displaying patchy high signal intensity within the lesion; E: Corresponding apparent diffusion coefficient map indicating low signal intensity, indicative of significantly restricted diffusion.

In the present study, we evaluated the radiographic characteristics of patients and discovered a significant difference in the average LTL and ATL between patients with poor and good prognoses, with the former exhibiting higher values (P < 0.05). In addition, although we also compared ATL/LTL, lymph node metastasis, and CRM between the two groups of patients, the differences between these indicators were not statistically significant (P > 0.05). This finding may indicate that these parameters play a limited role in predicting the prognosis of the disease or that more in-depth research is needed in future studies to reveal their potential relationship with disease prognosis (Figures 2 and 3).

Figure 2 Longitudinal tumor length, axial tumor length, and axial tumor length/longitudinal tumor length. A: Longitudinal tumor length (LTL) of patients with colorectal cancer; B: Axial tumor length (ALT) of patients with colorectal cancer; C: ATL/LTL of patients with colorectal cancer. ^aP < 0.05; LTL: Longitudinal tumor length; ATL: Axial tumor length.

Figure 3 Circumferential resection margin and lymph node metastasis. A: The number of positive and negative circumferential resection margin in patients with colorectal cancer; B: The number of positive and negative lymph node metastases in patients with colorectal cancer. CRM: Circumferential resection margin; +: Positive; -: Negative.

We conducted an in-depth analysis of the imaging parameters across the two patient groups to identify any potential disparities associated with varying disease prognoses. However, Kep did not show statistically significant variation between the different prognostic groups (P > 0.05), suggesting its limited efficacy in differentiating the prognosis of patients with CRC. Nonetheless, we observed substantial differences in the other imaging parameters, specifically K^trans, V_e, V_p, and ADC (P < 0.05). These significant variations imply that these parameters may be crucial for the prognostic assessment of CRC. Figure 4 provides a visual representation of the disparities in K^trans, V_e, V_p, and ADC values between the two patient groups to present these findings clearly.

Figure 4 Comparison of imaging parameters. A: Volume transfer constant of patients with colorectal cancer; B: Rate constant of patients with colorectal cancer; C: Volume of the extravascular extracellular space of patients with colorectal cancer; D: Plasma volume fraction of patients with colorectal cancer; E: Apparent diffusion coefficient of patients with colorectal cancer. ^aP < 0.05; K^trans: Volume transfer constant; K_ep: Rate constant; V_e: Volume of the extravascular extracellular space; V_p: Plasma volume fraction; ADC: Apparent diffusion coefficient.

Prognostic indicators of patients

In our analysis of the prognostic factors in patients with CRC, we identified significant disparities in various clinical indicators related to patient outcomes. Specifically, there were pronounced differences in operation time, perioperative bleeding, first exhaust, first defecation, eating recovery period, and hospital stay between patients with contrasting prognoses (P < 0.05). Patients with a favorable prognosis had an average hospital stay of approximately 10.57 days, whereas those with an unfavorable prognosis experienced prolonged hospitalization, averaging 14.25 days. Furthermore, the rate of postoperative complications varied significantly between the two groups. Patients with good prognosis had an average complication rate of approximately 3.95%, whereas those with poor prognosis had a markedly higher rate of 12.64%. To illustrate these differences more vividly, Figures 5 and 6 depict the variations in the perioperative indices and complication rates among patients with different prognoses.

Figure 5 Perioperative-related indicators for different prognoses. A: Operation time of patients with colorectal cancer; B: Perioperative bleeding in patients with colorectal cancer; C: First time of exhaust for patients with colorectal cancer; D: First time of defecation for patients with colorectal cancer; E: Eating recovery time for patients with colorectal cancer; F: Hospital stay for patients with colorectal cancer. ^aP < 0.05.

Figure 6  Comparison of postoperative complications between groups.

Correlation between imaging features of CRC and short-term prognosis of laparoscopic radical resection

In the logistic regression analysis, the primary outcome of interest was the patient prognosis at the 30-day mark after surgery. For this analysis, a favorable outcome was recorded as ‘0’, whereas an unfavorable outcome was recorded as ‘1’. The independent variables considered included LTL, ATL, ADC, K^trans, V_e, and V_p, all of which showed significant variance in the initial assessment of imaging features in the univariate analysis. A binary logistic regression model was constructed using these variables to examine their associations with the dependent variable. These findings indicate that LTL, ATL, ADC, K^trans, and V_p are predictive factors for short-term postoperative prognosis following laparoscopic radical resection. For the detailed results, please refer to Tables 1 and 2.

Table 1 Variable assignment table.

Index	Assignment method
LTL	Actual value entry
ATL	Actual value entry
ADC	Actual value entry
Ktrans	Actual value entry
Ve	Actual value entry
Vp	Actual value entry

LTL: Longitudinal tumor length; ATL: Axial tumor length; ADC: Apparent diffusion coefficient; K^trans: Volume transfer constant; V_e: Volume of the extravascular extracellular space; V_p: Plasma volume fraction.

Table 2 Logistic regression analysis.

Index	β	SE	Wald	P value	OR	95%CI
LTL	-0.190	0.067	8.093	0.004	0.827	0.726-0.943
ATL	1.397	0.372	14.065	< 0.001	4.042	1.948-8.386
ADC	-7.359	1.737	17.959	< 0.001	0.001	0.000-0.019
Ktrans	0.185	0.063	8.598	0.003	1.203	1.063-1.361
Ve	-0.043	0.047	0.840	0.359	0.958	0.873-1.051
Vp	-.260	0.116	5.050	0.025	0.771	0.614-0.967

LTL: Longitudinal tumor length; ATL: Axial tumor length; ADC: Apparent diffusion coefficient; K^trans: Volume transfer constant; V_e: Volume of the extravascular extracellular space; V_p: Plasma volume fraction; SE: Standard error; OR: Odds ratio.

The ROC curve results showed that LTL, ATL, ADC, K^trans, and V_p had predictive values for short-term prognosis of laparoscopic radical resection (P < 0.05), with AUC of 0.648, 0.927, 0.821, 0.809, and 0.831, respectively. The optimal cutoff value for LTL was 43.120, with a predictive sensitivity of 0.643 and specificity of 0.702 (P = 0.017). For ATL, the optimal cutoff value was 13.580, predictive sensitivity was 0.893, and specificity was 0.904 (P < 0.001). ADC had an optimal cutoff value of 0.370, with a predictive sensitivity of 0.607 and specificity of 0.883 (P < 0.001). K^trans had an optimal cutoff value of 32.090, with a predictive sensitivity of 0.714 and specificity of 0.968 (P < 0.001). The optimal cutoff value of V_p was 19.950, with a predictive sensitivity of 0.714 and specificity of 0.894 (P < 0.001). Further details are provided in Table 3 and Figure 7.

Figure 7 Receiver operating characteristic curve of imaging features for predicting short-term prognosis of laparoscopic radical resection. LTL: Longitudinal tumor length; ATL: Axial tumor length; ADC: Apparent diffusion coefficient; K^trans: Volume transfer constant; V_p: Plasma volume fraction.

Table 3 Receiver operating characteristic curve analysis table of imaging features predicting short-term prognosis of laparoscopic radical resection.

Index	AUC	Cutoff	SE	Sensitivity	Specificity	P value	95%CI
LTL	0.648	43.120	0.057	0.643	0.702	0.017	0.538-0.759
ATL	0.927	13.580	0.027	0.893	0.904	< 0.001	0.875-0.979
ADC	0.821	0.370	0.048	0.607	0.883	< 0.001	0.727-0.915
Ktrans	0.809	32.090	0.061	0.714	0.968	< 0.001	0.689-0.928
Vp	0.831	19.950	0.056	0.714	0.894	< 0.001	0.721-0.940

LTL: Longitudinal tumor length; ATL: Axial tumor length; ADC: Apparent diffusion coefficient; K^trans: Volume transfer constant; V_p: Plasma volume fraction; AUC: Area under the curve.

DISCUSSION

CRC is the third most prevalent malignancy globally and poses a significant threat to human health. In 2020, approximately 1.93 million individuals were diagnosed with the disease globally. The mortality rate associated with CRC is surpassed by that of lung cancer, making it the second leading cause of cancer-related deaths globally[7]. Patients often do not exhibit distinct symptoms during the initial stages of CRC development. However, as the tumor progresses and enlarges, patients may experience a growing frequency of bowel movements, a sensation of incomplete bowel evacuation, and potentially develop conditions such as intestinal narrowing or complete bowel obstruction. Additionally, it is common for patients to present with general symptoms such as diminished appetite and significant weight loss[8,9]. Clinical research indicates that nearly 85% of individuals with early-stage rectal cancer present with hematochezia as the sole clinical sign. However, these symptoms are frequently disregarded by patients, leading to delays in seeking medical intervention[10]. As imaging diagnostics continues to advance, the spatial resolution achievable using MRI technology has steadily improved. Consequently, an increasing array of functional MRI techniques are being integrated into clinical diagnostic practices[11,12].

Variations in MRI parameters can profoundly affect study outcomes, including the potential to degrade image quality and data reliability, produce artifacts and measurement errors, compromise the accuracy of tumor microvascular assessments and pathological grading predictions, diminish the reproducibility of radionic features, and modify the measurement results of the region of interest. It is imperative to control and standardize the MRI parameters strictly to ensure the precision and reliability of MRI findings. The MRI examination parameters used in this study conform to industry standards and have been meticulously optimized and adjusted by practical application and validated by a multitude of medical professionals and patients within the hospital. In this study, 22 of 122 patients with CRC showed low signal intensity and irregularly shaped tumor lesions, whereas the adjacent mucosa and submucosa showed relatively high signals. In 55 cases, low and high signals of the muscle layer alternately surrounded the tumor lesions, and the low signal of the muscle layer appeared as a complete continuous ring (among these, 46 cases of tumor lesions had rough edges or uneven signals, and 9 cases of lymph nodes on MRI images showed obvious high signals). In 32 cases, the tumor signal passed through the muscular layer, and the boundary between the muscular layer and the perienteric adipose tissue was blurred (among these, seven cases showed a high signal in the perienteric adipose tissue, which was mostly tortuous or nodular). Tumor signals were found in 13 adjacent tissues and organs, and the fat space between the adjacent tissues and organs was blurred (among these, three lymph nodes showed obvious high signals on MRI). Over the past few years, there have been significant advancements in the use of MRI for cancer, solidifying its role as an essential tool in the initial staging of tumors and formulation of treatment strategies. In the context of CRC, MRI is not limited to the evaluation of primary tumors and regional lymph nodes. It plays a crucial role in risk stratification by detecting indicators of high-risk tumors such as extramural vascular invasion. Furthermore, it is instrumental in evaluating the effectiveness of neoadjuvant chemoradiotherapy[13,14]. MRI enables radiologists to delineate the precise location and contour of tumors, aid in quantifying tumor dimensions, and categorize lymph node involvement. Additionally, it can confirm the presence of vascular invasion outside the tumor and ascertain the relationship between the tumor and the adjacent anatomical structures.

Laparoscopic surgery is a prevalent and minimally invasive approach for the treatment of CRC that offers benefits such as reduced patient trauma and quicker postoperative recovery. In cases of early to moderately advanced CRC, this surgical method has the potential to achieve a complete cure[15]. Despite the effectiveness of laparoscopic procedures in enhancing patient survival rates, the risks of postoperative metastasis and tumor recurrence persist and can significantly affect patient outcomes[16]. Our study findings indicate that patients with poor prognoses had notably higher LTL and ATL measurements than those with favorable prognoses. This finding suggests that elevated LTL and ATL values detected on MRI are indicative of a higher risk of unfavorable prognosis in patients with CRC. Elevated LTL and ATL levels may also reflect a more extensive tumor burden, which could be associated with rapid tumor growth and lower tumor differentiation grade, among other factors. Results of Hajibandeh et al[17] showed that, in patients with colon cancer, tumor size was an independent predictor of the number of harvested lymph nodes, positive lymph nodes, and lymphocytic infiltration. In tumor biology, the volume and growth rate of tumors is intrinsically linked to their proliferation. A larger tumor volume may suggest a higher tumor cell load and more complex tumor microenvironment, which can increase the complexity of surgery and extend postoperative recovery times. Tumor size is a crucial indicator of tumor cell proliferation. Increased tumor volume often implies heightened proliferation activity among tumor cells, typically associated with the invasiveness and metastatic potential of the tumor[18]. The results of Dai et al[19] showed that tumor size is an independent factor for overall survival and disease-free survival in patients with infiltrative colorectal adenocarcinoma. Due to potential hypoxia and inadequate nutrient supply in the central regions of the tumor, larger tumors may undergo necrosis, which can affect the tumor’s response to treatment and the patient's prognosis. Furthermore, larger tumors often indicate advanced staging, leading to poorer prognosis and necessitating more complex surgical interventions. This outcome increases the risk associated with surgery and the likelihood of postoperative complications, thereby affecting the short-term prognosis of patients.

Within the scope of this study, we observed that patients with a poor prognosis exhibited significantly elevated levels of K^trans, V_e, and V_p than those with a more favorable outcome. Conversely, the ADC values were markedly lower in the former group. Our analysis suggests that patients with CRC with a negative outlook tend to have less mature vascular development and a reduced muscular component, resulting in increased vascular permeability of the tumor. This heightened permeability allows for rapid infiltration of contrast medium into the interstitial space of the tumor. In contrast, patients with a favorable prognosis have tumor vascular permeability closer to normal levels, accounting for the relatively higher K^trans, V_e, and V_p values observed in patients with poor prognoses[20,21]. K^trans is an indicator of vascular permeability, blood flow, and microvascular density and provides insight into the rate at which the contrast agent diffuses from the vascular space into the extravascular extracellular space. Elevated K^trans levels indicated a higher malignant grade of the lesion. The K^trans value is intricately linked to tumor angiogenesis, which is the key connection between tumor growth and metastasis. Generally, higher K^trans values indicate increased angiogenic activity, which may affect the invasiveness of tumors and, by extension, patient prognosis[22]. Ve is a measure of the extracellular volume fraction, which represents the metabolic capacity of the contrast agent within the tumor.

Conversely, Vp signifies average vascular density and is particularly responsive to changes in perfusion within the tumor vasculature. An increase in these parameters is associated with enhanced blood perfusion to the tumor, suggesting a more aggressive tumor behavior and potentially poorer patient outcomes[23,24]. ADC quantifies the diffusion rate and extent of movement of water molecules. This result serves as a descriptor of the diffusional mobility of water molecules in various spatial orientations. The cellular density of tissue influences the ADC value. With an increase in cell density, intercellular spaces become narrow, the intracellular environment undergoes alterations, and the mobility of water molecules is constrained. This restriction leads to heightened signals in diffusion-weighted MRI scans and a corresponding decrease in ADC values[25]. The findings of this study indicate that parameters such as LTL, ATL, ADC, K^trans, V_e, and V_p can predict short-term outcomes after laparoscopic radical resection surgery. The areas under the ROC curves for these parameters were 0.648, 0.927, 0.821, 0.809, and 0.831, with sensitivity values of 0.643, 0.893, 0.607, 0.714, and 0.714 and specificities of 0.702, 0.904, 0.883, 0.968, and 0.894, respectively. These results suggest a correlation between imaging biomarkers and the short-term prognosis of laparoscopic radical resection. The current investigation was a retrospective analysis conducted at a single medical center, and the relatively brief follow-up period could have introduced bias into the findings. In our subsequent research, we plan to expand our approach by initiating a multicenter large-scale study involving collaboration among multiple hospitals. This plan will be complemented by long-term follow-up to establish a more robust and reliable foundation for the prognostic utility of imaging biomarkers in patients with CRC.

CONCLUSION

In our study, we analyzed the radiographic characteristics of CRC and their association with short-term outcomes in patients undergoing laparoscopic radical resection. These findings suggest that these imaging biomarkers have predictive significance and are correlated with short-term prognoses. This insight can serve as a valuable reference point for clinical decision-making and may contribute to the refinement of individualized treatment strategies. It is essential to adopt a holistic approach when applying these findings and thoroughly assessing the prognosis of each patient, considering their unique circumstances and medical histories.