Assessment of local stage in rectal cancer using endorectal ultrasonography (EUS)

Bali, Christina; Nousias, Vasilios; Fatouros, Michael; Stefanou, Dimitrios; Kappas, Angelos M.

doi:10.1007/s10151-004-0147-4

Cited by 15 publications

(7 citation statements)

References 6 publications

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“…In our study, we overstaged four T2 tumors, and these were probably related to artifacts from tissue edema or inflammation. Consistent with other literature results, our study showed that ERUS was 86% accurate in assessing rectal wall penetration [4,[6][7][8][9][10][11][12][13][14][15][16][17][18]. In our results, a learning curve for T staging was not apparent.…”

Section: Discussionsupporting

confidence: 92%

“…As revealed by our results, 60% of our patients underwent ERUS concurrently during the same colonoscopic session. With reported accuracy rates of 69-92%, ERUS is believed to be the most accurate investigative choice in determining depth of rectal tumor invasion [4,[6][7][8][9][10][11][12][13][14][15][16][17][18]. Accurate tumor staging is important in selecting patients for possible multimodality treatment including preoperative chemoradiation, which may be beneficial in locally advanced tumors.…”

Section: Discussionmentioning

confidence: 99%

“…As it is an operator-dependent examination, its accuracy is closely related to endosonographer experience. Reported accuracy is variable, ranging from 69 to 92% for tumor staging and from 64 to 85% for nodal staging [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. It is understandable that accuracy rates may improve after the learning curve of the procedure has been overcome.…”

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confidence: 99%

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The learning curve for endorectal ultrasonography in rectal cancer staging

Liu

et al. 2010

Surg Endosc

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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The learning curve for endorectal ultrasonography in rectal cancer staging

Liu

et al. 2010

Surg Endosc

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“…Many studies have reported on the accuracy of ERUS (Table 1). 10,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Despite a wide range of results, common patterns have emerged. One is that the accuracy of ERUS T-staging varies in relation to tumor stage; ERUS tends to be least accurate in assessing intramural T2 masses, which are often overstaged.…”

Section: Staging Accuracymentioning

confidence: 99%

Endorectal Ultrasound: Its Role in the Diagnosis and Treatment of Rectal Cancer

Edelman

Weiser²

2008

Clinics in Colon and Rectal Surgery

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With development over the past 25 years of new surgical techniques and neoadjuvant therapy regimens for rectal cancer, physicians now have a range of treatment options that minimize morbidity and maximize the potential for cure. Accurate pretreatment staging is critical, ensuring adequate therapy and preventing overtreatment. Many options exist for staging primary rectal cancer. However, endorectal ultrasound (ERUS) remains the most attractive modality. It is an extension of the physical examination, and can be performed easily in the office. It is cost effective and is generally well tolerated by the patient, without need for general anesthesia. The authors discuss the data currently available on ERUS, including its accuracy and limitations, as well as the technical aspects of performing ERUS and interpreting the results. They also discuss new ultrasound technologies, which may improve rectal cancer staging in the future. KEYWORDS: Endorectal ultrasound, rectal cancer, evaluation, stagingObjectives: On completion of this article, the reader should be able to understand the current role, the potential roles, and the limitations of endorectal ultrasound in the evaluation of rectal cancer.Rectal cancer remains a significant health concern worldwide, affecting over 40,000 people annually 1 in the United States alone. Recurrence rates approach 50% in the setting of stage II and III disease.2 The narrow confines of the bony pelvis make surgical extirpation challenging. Incomplete resection leads to local recurrence, 3 which is associated with high morbidity. Postoperative chemoradiation has been shown to reduce the rate of local relapse from 25% to 16%, prompting the National Institutes of Health (NIH; Bethesda, MD) to issue a consensus statement advocating adjuvant therapy for all stage II and III rectal cancer patients.4-6 A recent prospective, randomized trial by the German Rectal Cancer Study Group demonstrated that preoperative chemoradiation results in even lower rates of local recurrence, reduced treatment toxicity, and improved rates of sphincter preservation.7 Indeed, many series reporting on combined modality therapy (CMT)-preoperative chemoradiation followed by total mesorectal excision-demonstrate local recurrence rates of less than 10% 8 in the setting of locally advanced lesions. These studies highlight the need for proper staging prior to initiation of treatment. 9Endorectal ultrasound is currently the most widely used and effective diagnostic modality in the assessment of rectal cancer overall. Its accuracy in numerous trials and meta-analyses ranges from 80 to 95% for T-staging and 70 to 75% for N-staging, levels that

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“…Previous studies of ERUS have reported T-staging accuracy between 60 and 90% [22,23] and N-staging accuracy between 59 and 82% [24,25]. Meta-analysis of tumour staging demonstrates sensitivity results for T1, T2, T3 and T4 stages of 87, 80, 96 and 95%, respectively.…”

Section: Discussionmentioning

confidence: 82%