Prognostic Heterogeneity of Endosonographic T3 Rectal Cancer

Abstract

A maximum tumor thickness measured by endorectal ultrasound in pT3 rectal cancer is an independent prognostic factor for local and overall recurrence. An ultrasound maximum tumor thickness cutoff point of 19 mm may be useful to classify patients preoperatively and to select them for primary surgery or neoadjuvant therapy.

Modified Wong's Classification Improves the Accuracy of Rectal Cancer Staging by Endorectal Ultrasound and MRI

“…15,17,20 endorectal ultrasound has become the most common diagnostic method for local staging of rectal cancer because of its availability and its accuracy in the determination of the depth of wall penetration and lymph node metastases. 12,13,15,26 in our study, the overall accuracy of eRus in assessing t stage with the use of standard tn classification was 68.6%, with 27.1% of the tumors overstaged and 4.3% understaged. 12,13,15,26 in our study, the overall accuracy of eRus in assessing t stage with the use of standard tn classification was 68.6%, with 27.1% of the tumors overstaged and 4.3% understaged.…”

“…using eRus, we subdivided ut3 rectal tumors into ut3a and ut3b by using a tumor thickness cutoff point of 19 mm as described by esclapez et al 12 similarly, with the use of mRi, rt3 tumors were subdivided into rt3a and rt3b with a cutoff point of 5 mm, according to the Brown criteria. 19 the modified eRus Wong-esclapez classification and mRi Wong-Brown classification are summarized in figure 1.…”

“…15,16 however, Wong did not define specific cutoff points of the division of these subgroups in either of the 2 articles. esclapez et al 12 proposed an eRus subdivision of t3 tumors into ut3a and ut3b based on maximum tumor thickness with a cutoff point of 19 mm. for this reason, we decided to use cutoff points with more solid evidence.…”

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

“…Maximal tumor thickness (MTT) also has been used for substaging. Esclapez et al divided the T3 stage into uT3a (uMTT ≤19 mm) and uT3b (uMTT >19 mm) (22). They believed that because the muscularis propria was replaced by tumor, the ERUS would be unlikely to clearly show the muscularis propria.…”

Rectal Cancer and Anal Sphincter Disorders

“…However, the challenge is that overstaging is noted more commonly in minimally invasive T3 (50 %) when compared to advanced T3 disease [16]. The maximum tumor thickness of T3 cancers is also an independent prognostic factor for local and overall recurrence [17] using a cutoff value of ≥ 19 mm.…”