How useful is rectal endosonography in the staging of rectal cancer? (original) (raw)
Related papers
Is endorectal ultrasound still useful for staging rectal cancer?
Staging in rectal carcinoma is important for planning treatment. Preoperative staging and treatment strategies have changed along with improvements in imaging techniques. The aim of this work is to evaluate the accuracy of endorectal ultrasound (ERUS) in rectal cancers, especially in low rectal cancers and stenotic cases.
Endoscopic ultrasound: current role and future perspectives in managing rectal cancer patients
Journal of gastrointestinal and liver diseases : JGLD, 2011
As therapeutic regimens for rectal cancer have seen considerable changes, an accurate staging is mandatory for choosing the adequate strategy. Locoregional staging is the decisive factor in selecting patients for neoadjuvant chemoradiation therapy and for determining the extent of surgery. Endoscopic ultrasound (endorectal ultrasound--ERUS) is a very effective method for assessing the local extent of rectal cancer, especially regarding the depth of tumor infiltration. Although a significant limitation is represented by its lower accuracy for diagnosis of lymph node metastases, this is still a point of concern for other imaging tests as well. In this review we report the current data on ERUS, presenting both its advantages and limitations, and making a comparison to other staging methods. Recent developments of the technology that might enhance staging accuracy are also discussed.
Accuracy of Endorectal Ultrasonography in Preoperative Staging of Rectal Tumors
Diseases of The Colon & Rectum, 2002
PURPOSE: Preoperative staging of rectal tumors is considered essential to tailor treatment for individual patients. The aim of the present study was to evaluate the accuracy of endorectal ultrasonography in preoperative staging of rectal tumors. METHODS: Eleven hundred eighty-four patients with rectal adenocarcinoma or villous adenoma underwent endorectal ultrasonography evaluation at a single institution during a ten-year period. We compared the endorectal ultrasonography staging with the pathology findings based on the surgical specimens in 545 patients who had surgery (307 by transanal excision, 238 by radical proctectomy) without adjuvant preoperative chemoradiation. Comparisons between groups were performed using chi-squared tests and logistic regression analysis. RESULTS: Overall accuracy in assessing the level of rectal wall invasion was 69 percent, with 18 percent of the tumors overstaged and 13 percent understaged. Accuracy depended on the tumor stage and on the ultrasonographer. Overall accuracy in assessing nodal involvement in the 238 patients treated with radical surgery was 64 percent, with 25 percent overstaged and 11 percent understaged. CONCLUSION: The accuracy of endorectal ultrasonography in assessing the depth of tumor invasion, particularly for early cancers, is lower than previously reported. The technique is more precise in distinguishing between benign tumors and invasive cancers and between tumors localized to the rectal wall and tumors with transmural invasion. Differences in image interpretation may in part explain discrepancies in accuracy between studies.
European journal of gastroenterology & hepatology, 2018
Treatment and prognosis of patients with rectal adenocarcinoma (RAC) are dependent on accurate locoregional staging. The aim of this study was to measure the performance characteristics of rectal endoscopic ultrasound (EUS) compared with surgical pathology, and to assess the interobserver variation of rectal EUS in the staging of RAC. Patients referred for rectal EUS staging of a recently diagnosed RAC were prospectively enrolled between 2012 and 2016. Tandem EUS exams were performed by two independent endosonographers (ES1 and ES2) blinded to each other's findings. Ninety-five patients were enrolled. Seventy-five (79%) underwent curative intent tumor resection, including 30 without neoadjuvant therapy. In this latter group, the sensitivity, specificity, and accuracy of transrectal ultrasonography staging were 75, 83, and 82% for uT1; 50, 65, and 58% for uT2; 56, 81, and 73% for T3; 72, 44, and 63% for N0, and 38, 75, and 63% for N1, respectively. Experienced operators rendered ...
Endoscopic ultrasound in the pre-operative staging of rectal carcinoma
Gastrointestinal Endoscopy, 1992
Endoscopic ultrasound (EUS) was performed prospectively to stage 45 patients with rectal cancer. Patients were staged utilizing the TNM staging system. All patients subsequently underwent surgical resection with independent histopathologic staging. Depth of invasion was accurately predicted in 40 of 45 patients (89%). Presence or absence of lymph node metastasis was correctly determined in 34 of 45 patients (79%). EUS is an accurate method for local staging of rectal cancer. (Gastrointest Endosc 1992;38:468-471)
Medical ultrasonography, 2015
Endoscopic ultrasound is the most accurate type of examination for the assessment of rectal tumors. Over the years, the method has advanced from gray-scale examination to intravenous contrast media administration and to different types of elastography. The multimodal approach of tumors (transrectal, transvaginal) is adapted to each case. 3D ultrasound is useful for spatial representation and precise measurement of tumor formations, using CT/MR image reconstruction; color elastography is useful for tumor characterization and staging; endoscopic ultrasound using intravenous contrast agents can help study the amount of contrast agent targeted at the level of the tumor formations and contrast wash-in/wash-out time, based on the curves displayed on the device. The transvaginal approach often allows better visualization of the tumor than the transrectal approach. Performing the procedure with the rectal ampulla distended with contrast agent may be seen as an optimization of the examinatio...
Role of endoscopic ultrasonography in the loco-regional staging of patients with rectal cancer
The prognosis of rectal cancer (RC) is strictly related to both T and N stage of the disease at the time of diagnosis. RC staging is crucial for choosing the best multimodal therapy: patients with high risk locally advanced RC (LARC) undergo surgery after neoadjuvant chemotherapy and radiotherapy (NAT); those with low risk LARC are operated on after a preoperative short-course radiation therapy; finally, surgery alone is recommended only for early RC. Several imaging methods are used for staging patients with RC: computerized tomography, magnetic resonance imaging, positron emission tomography, and endoscopic ultrasound (EUS). EUS is highly accurate for the loco-regional staging of RC, since it is capable to evaluate precisely the mural infiltration of the tumor (T), especially in early RC. On the other hand, EUS is less accurate in restaging RC after NAT and before surgery. Finally, EUS is indicated for follow-up of patients operated on for RC, where there is a need for the surveillance of the anastomosis. The aim of this review is to highlight the impact of EUS on the management of patients with RC, evaluating its role in both preoperative staging and follow-up of patients after surgery.
Endorectal ultrasound in the diagnosis of rectal cancer: Accuracy and criticies
International Journal of Surgery, 2014
You may download, copy and otherwise use the AAM for non-commercial purposes provided that your license is limited by the following restrictions: (1) You may use this AAM for non-commercial purposes only under the terms of the CC-BY-NC-ND license. (2) The integrity of the work and identification of the author, copyright owner, and publisher must be preserved in any copy.