Clinical implications of quantification of mesorectal tumor invasion by endoscopic ultrasound: All T3 rectal cancers are not equal

Abstract

All T3 rectal tumors are not equal, with minimally invasive disease carrying a more favorable prognosis. By discriminating minimally invasive from advanced T3 disease, preoperative EUS provides important prognostic information. Further subclassification of T3 tumors, based on preoperative EUS staging, should be considered to enhance selection of patients for neoadjuvant therapy.

Prognostic Heterogeneity of Endosonographic T3 Rectal Cancer

“…15 However, there are very few descriptions of the subdivision of T3 tumors using ERUS. 16,17 The aims of this study were to assess the oncologic prognostic value of ERUS subdivision of T3 tumors using tumor thickness and to analyze the correlation between this ultrasound-based parameter and other prognostic factors.…”

Rectal Cancer and Anal Sphincter Disorders

“…It is thought that all T3 rectal tumors are not clinically equivalent, with minimally invasive disease carrying a more favorable prognosis [15]. Therefore, by discriminating minimally invasive from advanced T3 disease (invasion ≤ 2 mm or > 3 mm beyond the muscularis propria), preoperative EUS may provide important prognostic information.…”

Value of endorectal ultrasonography in measuring the extent of mesorectal invasion and substaging of T3 stage rectal cancer

“…Harewood et al divided T3 stage rectal cancer into minimally invasive T3 (EMI ≤2 mm) and advanced T3 (EMI >2 mm) substages (17). Rafaelsen et al divided T3 stage rectal cancer into four substages according to UICC standards: T3a (EMI: 0-1 mm), T3b (EMI: 2-5 mm), T3c (EMI: 5-15 mm), and T3d (EMI >15 mm).…”

“…Endorectal ultrasound (ERUS) has advantages in TN staging over MRI, such as higher accuracy, lower cost, and easier operation (15). However, the value of ERUS in assessing the EMI has not been widely recognized (16)(17)(18).…”