Accuracy of endorectal ultrasonography in staging locally advanced rectal cancer after preoperative chemoradiation

Radovanović, Zoran; Breberina, Milan; Petrović, Tamaš; Golubovic, A.; Radovanović, Dragana

doi:10.1007/s00464-008-0037-3

Cited by 50 publications

(32 citation statements)

References 17 publications

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“…In the mis-staged cases, understaging was more common than overstaging, similar to the results of previous studies. 8,23,29 The reasons for sonographic N understaging Stage T1 T2 T3 T4 Overstaging Understaging T1 13 0 0 0 0 0 T2 2 78 6 1 2 7 T3 0 5 56 9 5 9 T4 0 0 3 19 3 0 Sonographic stage T1 represents tumors confined to the mucosa and submucosa; T2, tumors confined to the rectal wall; T3, tumors penetrating the rectal wall and invading the hyperechoic perirectal fat; and T4, tumors invading adjacent organs.…”

Section: Discussionmentioning

confidence: 99%

Application of Endoscopic Sonography in Preoperative Staging of Rectal Cancer

Lin

Luo

Gao

et al. 2011

Journal of Ultrasound in Medicine

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Six-Year Experience n recent years, the development of new surgical techniques and use of neoadjuvant therapy have modified the management and improved the prognosis of rectal cancer. The selection of suitable treatment strategies for rectal cancer is based on accurate staging of the lesions. Several methods have been reported for imaging rectal cancer, such as sonography, computed tomography, magnetic resonance imaging (MRI), and positron emission tomography/computed tomography. [1][2][3][4][5][6][7][8][9][10][11][12] Computed tomography and MRI have advantages of imaging distant metastases (M staging), but for locoregional invasion imaging (T and N staging), endoscopic sonography may be a better choice, especially for assessing the invasive depth of a lesion (T staging). Several studies have shown good accuracy for endoscopic sonography in rectal cancer staging. 3,4,7,8,13 These studies showed that the overall accuracy of T staging fluctuated from 72% to 90%, and the overall accuracy of N staging ranged from 69% to 80%.Shiyong Lin, PhD, Guangyu Luo, MD, Xiaoyan Gao, Hongbo Shan, MD, Yin Li, MD, Rong Zhang, MD, Jianjun Li, MD, Longjun He, PhD, Guobao Wang, PhD, Guoliang Xu, MD Received January 20, 2011, ORIGINAL RESEARCHObjectives-The aim of this study was to evaluate our experience with the application of endoscopic sonography in preoperative staging of rectal cancer. April 2004 and May 2010, 192 patients with rectal cancer first underwent endoscopic sonography and then underwent surgery at our hospital. None of the patients in this study received neoadjuvant therapy. The endoscopic sonographic staging results were compared with those of postoperative pathologic staging. Methods-BetweenResults-The accuracy of overall T staging was 86.5%, and for T1, T2, T3, and T4, the accuracy rates were 86.7%, 94.0%, 86.2%, and 65.5%, respectively. The accuracy of T staging for ulcerated lesions was significantly lower than that for nonulcerated lesions (P = .013). The accuracy of T staging between nontraversable stenotic lesions and traversable lesions was also significantly different (P = .002). The accuracy of N staging was 77.8%, and the specificity and sensitivity were 85.6% and 74.2%, respectively.Conclusions-Endoscopic sonography is safe and effective for preoperative staging of rectal cancer and should be a routine examination before surgery. As for ulcerated and nontraversable stenotic lesions, however, the results of endoscopic sonographic staging could be doubtful. Moreover, the accuracy of endoscopic sonographic N staging still needs modification by further research.

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Section: Discussionmentioning

confidence: 99%

Application of Endoscopic Sonography in Preoperative Staging of Rectal Cancer

Lin

Luo

Gao

et al. 2011

Journal of Ultrasound in Medicine

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“…В целом показатели токсичности были приемлемыми и соответ-ствовали данным крупных зарубежных рандомизиро-ванных исследований, где также использовали оксали-платин в сочетании с фторпиримидинами [14,15]. При сравнении межгрупповых показателей токсичности наи-более предпочтительным вариантом неоадъювантного лечения выглядит ЛТ на фоне приема капецитабина или оксалиплатина+капецитабина.…”

Section: Discussionunclassified

Neoadjuvant therapy for locally advanced rectal cancer

Бердов¹,

Erygin²,

Nevolskikh³

et al. 2018

Onkol. Z. im. P.A. Gercena

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“…A szakirodalomban a re-staging pontossága a T-stádi-um tekintetében széles határok között mozog (27-75%) [1,[7][8][9][10][11][12][13][14][15][16][17]. Marone és mtsai 6 éves periódusban hasonlí-tották össze az előrehaladott rectumtumorok stagingjé-nek és a neoadjuváns kezelést követő re-stagingjének RUH pontosságát 85 beteg bevonásával.…”

Section: áBraunclassified

“…A patológiai elemzés alapján ypT0 stádiumú 10 daganatot egyik esetben sem tudták ultrahanggal azonosítani. Az ypT0 stádium azonosítása Radovanovic és mtsai szá-mára is nehézséget jelentett: 5 esetből csupán egy alkalommal született pontos ultrahangos stádiummeghatá-rozás, annak ellenére, hogy a re-staging pontosságát 75%-nak határozták meg a T-stádium esetén [14]. Az egyes stádiumokra lebontva Martellucci T3-stádiumú rectumtumorok esetén kiemelkedően magas pontosság-ról számol be (96%) [15].…”

Section: áBraunclassified

“…Az N-stádium meghatározásánál az irodalmi adatok 39-83% között mozognak a re-staging során [1,[7][8][9][10][11][12][13][14][15][16][17], egy áttekintő tanulmány az átlagos pontosságot 70%-ként határozta meg [18]. Míg az iniciális stádiummegha-tározás során az N-staging pontossága rendszerint elmarad a T-staginghez képest [1], re-staging után ez a különbség nem számottevő.…”

Section: áBraunclassified

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A neoadjuváns kezelés mint a rectalis ultrahangvizsgálat korlátozó tényezője

et al. 2016

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Bevezetés: A rectalis ultrahang a rectumtumorok stagingjének egyik alapmódszere. Előrehaladott tumorok esetén a műtét előtti neoadjuváns kezelés hatására létrejövő szöveti változások hatással vannak a módszer pontosságára. Cél-kitűzés: A rectalis ultrahang pontosságának felmérése preoperatív kemo-radioterápiát követően, összehasonlítva az iniciális staging során tapasztalt pontossággal. Módszer: Retrospektív módon vetették össze a Szegedi Tudomány-egyetem I. Belgyógyászati Klinikán 2006 és 2014 között végzett rectalis ultrahangvizsgálatok során meghatározott T-, illetve N-stádiumot a műtéti reszekátum feldolgozásakor megadott patológiai T-és N-stádiummal neoadjuváns kezelést követően és az iniciális staging során (kontrollcsoport). Eredmények: A T-stádium esetén az iniciális staging 70%-ban, a re-staging 61%-ban volt pontos, utóbbinál 31%-ban túlértékelés történt. Az ypT0 stádiumot egy esetben sem sikerült azonosítani. Az N-stádium meghatározásának pontossága 64% volt a kontrollcsoportban és 61% volt restaging alkalmával. Következtetések: Neoadjuváns kezelést követően a rectalis ultrahang pontossága romlik. Az onkológiai kezelés hatásosságának megítélésében és a műtéti tervezésben a rectalis ultrahanggal történő re-staging szerepe megkérdőjelezhető. Orv. Hetil., 2016, 157(30), 1193-1197. Kulcsszavak: rectumcarcinoma, rectalis ultrahang, staging, neoadjuváns kezelés Neoadjuvant treatment as a limiting factor to rectal ultrasonographyIntroduction: Rectal ultrasonography is a basic method for staging rectal cancer. Tissue changes after neoadjuvant treatment alter the accuracy of the method. Aim: The aim of the authors was to assess the accuracy of rectal ultrasonography after preoperative chemo-radiotherapy compared to the initial staging accuracy. Method: Rectal ultrasounds performed between 2006 and 2014 were assessed retrospectively. Ultrasonographic and pathological T and N stages were compared both in case of initial staging (control group) and re-staging. Results: T staging was accurate in 70% in the control group and in 61% in re-staging. Rate of overstaging was 31% after neoadjuvant treatment. None of the ypT0 cases were identified. N staging accuracy was 64% in the control group and 61% in re-staging. Conclusions: Neoadjuvant treatment impairs the accuracy of rectal ultrasound. The role of re-staging with rectal ultrasonography is debatable in the assessment of the efficacy of oncological treatment and surgical planning.

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Accuracy of endorectal ultrasonography in staging locally advanced rectal cancer after preoperative chemoradiation

Abstract: ERUS provides a good accuracy rate for staging rectal cancer after neoadjuvant chemoradiation. However, it is insufficient in detection of complete pathological response.

Cited by 50 publications

References 17 publications

Application of Endoscopic Sonography in Preoperative Staging of Rectal Cancer

Application of Endoscopic Sonography in Preoperative Staging of Rectal Cancer

Neoadjuvant therapy for locally advanced rectal cancer

A neoadjuváns kezelés mint a rectalis ultrahangvizsgálat korlátozó tényezője

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