Evaluation of endoscopic ultrasonography in colorectal villous lesions

Konishi, Kazuo; Akita, Yasushi; Kaneko, Kazuhiro; Kurahashi, Toshinori; Yamamoto, Tomoaki; Kusayanagi, Satoshi; Yoshikawa, Nozomi; Miyasaka, N; Tajiri, Hisao; Mitamura, Keiji

doi:10.1007/s00384-002-0423-6

Cited by 20 publications

(10 citation statements)

References 22 publications

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“…However, the accuracy of mEUS in differentiating between tumors of SM1 subclass or lower (M and SM1) and tumors of SM2 class or higher (SM2, SM3, muscularis propria, and serosa) was 85.7% (30/35). In the current study, we demonstrated that large tumor size decreased the accuracy of T staging by mEUS, which is consistent with the findings of other studies 4,25. Interestingly, in cases in which the tumor had invaded the submucosa and tumor size was >2 cm, the OR was 14.67 (95% CI, 1.46 to 146.96), suggesting that the accuracy of mEUS had dramatically decreased.…”

Section: Discussionsupporting

confidence: 91%

“…Therefore, we suggest that extra caution should be taken when performing mEUS to predict the T stage in submucosal tumors that are >2 cm in size. Several studies have suggested that the accuracy of mEUS was lower in pedunculated-type tumors, villous lesions or tumors located in the rectum 13,25. However, in our study, the shape, location, and histopathological findings such as tumor differentiation or lymphovascular invasion had no effects on the accuracy of T staging by mEUS.…”

Section: Discussioncontrasting

confidence: 80%

“…For example, mEUS is not suitable for the evaluation of regional lymph node invasion, and mEUS cannot accurately differentiate between stages T3 and T4 because mEUS typically uses high frequency ultrasound, which limits the depth of penetration. In addition, according to previous studies, the accuracy of mEUS may decrease with increasing tumor size, advanced tumor stage, pedunculated-type tumors, villous lesions, and rectal tumors 4,13,25. Results can also be influenced by inadequate contact between the tumor and the probe due to air, stool, or irregular tumor surfaces, anatomic defects from previous biopsies or polypectomy, and peritumoral inflammation.…”

Section: Discussionmentioning

confidence: 89%

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Miniprobe Endoscopic Ultrasonography Has Limitations in Determining the T Stage in Early Colorectal Cancer

Tsung

Park²,

Kim³

et al. 2013

Gut Liver

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Background/AimsMini-probe endoscopic ultrasonography (mEUS) is a useful diagnostic tool for accurate assessment of tumor invasion. The aim of this study was to estimate the accuracy of mEUS in patients with early colorectal cancer (ECC).MethodsNinety lesions of ECC underwent mEUS for pre-treatment staging. We divided the lesions into either the mucosal group or the submucosal group according to the mEUS findings. The histological results of the specimens were compared with the mEUS findings.ResultsThe overall accuracy for assessing the depth of tumor invasion (T stage) was 84.4% (76/90). The accuracy of mEUS was significantly lower for submucosal lesions compared to mucosal lesions (p=0.003) and it was lower for large tumors (≥2 cm) (p=0.034). The odds ratios of large tumors and submucosal tumors affecting the accuracy of T staging were 3.46 (95% confidence interval [CI], 1.05 to 11.39) and 6.25 (95% CI, 1.85 to 25.14), respectively. When submucosal tumors were combined with large size, the odds ratio was 14.67 (95% CI, 1.46 to 146.96).ConclusionsThe overall accuracy of T stage determination with mEUS was considerably high in patients with ECC; however, the accuracy decreased when tumor size was >2 cm or the tumor had invaded the submucosal layer.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 80%

Section: Discussionmentioning

confidence: 89%

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Miniprobe Endoscopic Ultrasonography Has Limitations in Determining the T Stage in Early Colorectal Cancer

Tsung

Park²,

Kim³

et al. 2013

Gut Liver

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“…Pikarsky (56) from Cleveland Clinic showed that ERUS confirmed the histopathologic diagnosis of rectal villous tumor without evidence of malignancy in 26 out of 27 patients. Konishi et al (57) reported that the overall accuracy of ERUS-based evaluation of tumor invasion depth was 60% in villous lesions and 91% in non-villous lesions. In differentiating mucosa neoplasias (M)/ submucosal cancers with slight invasion (SM-s) from non M/SM-s the accuracy of ERUS in villous and nonvillous lesions was 66% and 96%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Staging of Rectal Cancer: Role of Endorectal Ultrasound

A.G.F.¹,

Grobler²,

Santoro³

2011

Rectal Cancer - A Multidisciplinary Approach to Management

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“…Une méta-analyse sur 11 études (1 791 patients) montre une sensibilité de 97,3 % (IC 95 % : 93,7-99,1) et une spécificité de 96,3 % (IC 95 % : 95,3-97,2) pour le diagnostic des lésions T0 [6]. L'écho-endoscopie surestime l'invasion de la sous-muqueuse pour différencier une invasion sm1 versus ≥ sm2 surtout pour les lésions villeuses rectales de grande taille (diamètre ≥ 20 mm ou hauteur ≥ 5 mm), avec une sensibilité de 60 %, une précision de 66 % mais une spécificité qui reste proche de 100 % [7].…”

Section: Diagnostic Endoscopique De Malignitéunclassified

Que faire devant une tumeur superficielle étendue du rectum ?

Samaha

Cellier

2010

Acta Endosc

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Les tumeurs rectocoliques à développement latéral ou lateral spreading tumors (LST) sont des lésions planes ou sessiles à extension latérale et circonférentielle endoluminale, qui peuvent être de type granulaire (LST-G) ou non granulaire (LST-NG). Leur diagnostic repose sur l'endoscopie de haute définition avec magnification et les techniques de coloration. Le risque d'invasion de la sousmuqueuse est plus marqué pour les LST-NG surtout quand elles sont de type pseudodéprimé. Le traitement de ces tumeurs fait appel à l'endoscopie interventionnelle, plus particulièrement la résection par mucosectomie endoscopique (ME) adaptée aux lésions de moins de 2 cm ou aux LST-G par mucosectomie fragmentée. La dissection sous-muqueuse (DSM) permet de réséquer en bloc des lésions sans limite de taille. Elle est plus adaptée aux LST-NG et aux lésions plus étendues suspectes. La microchirurgie transanale endoscopique (TEM) est une alternative moins invasive au traitement chirurgical classique. La DSM des tumeurs rectales reste en cours d'évaluation dans le cadre d'un protocole de la SFED en partenariat avec l'INCa. Mots clés Tumeur plane · Rectum · Mucosectomie endoscopique · Dissection sous-muqueuseAbstract Lateral spreading tumors are superficial spreading neoplasms now increasingly diagnosed using high definition endoscopy and chromoscopic colonoscopy. There are two types of LST: granular type (LST-G) and non-granular type, (LST-NG). LST-NG type, especially the pseudodepressed type, has a significantly higher frequency of submucosal invasion than LST-G type. LSTs are usually removed, therefore, by endoscopic mucosal resection (EMR) but larger tumors (> 2 cm) may require piecemeal resection in case of LST-G type. Endoscopic submucosal dissection (ESD) allows en-bloc resection irrespective of the size of the lesion and is indicated in LST-NG type or large elevated lesions suspected to be carcinoma. Transanal endoscopic microsurgery (TEM) offers a minimally invasive alternative to radical surgery. Rectal ESD is still under evaluation in France in a SFED/INCa prospective trial.

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Evaluation of endoscopic ultrasonography in colorectal villous lesions

Abstract: It is difficult to determine the depth of invasion in villous lesions, especially large or rectal lesions, using only EUS. EUS-based evaluation alone cannot determine the appropriate treatment for colorectal villous lesions.

Cited by 20 publications

References 22 publications

Miniprobe Endoscopic Ultrasonography Has Limitations in Determining the T Stage in Early Colorectal Cancer

Miniprobe Endoscopic Ultrasonography Has Limitations in Determining the T Stage in Early Colorectal Cancer

Preoperative Staging of Rectal Cancer: Role of Endorectal Ultrasound

Que faire devant une tumeur superficielle étendue du rectum ?

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