Rectal cancer: CT local staging with histopathologic correlation

Abstract

CT correctly staged 86 (82%) of 105 lesions. Overestimation occurred in T2 patients (11 of 61, 18%) and underestimation in T3 patients (seven of 33, 21%), in accordance with other reports dealing with superior accuracy of endorectal ultrasonography in local staging of early disease. Conversely, the criterion we suggest for evaluating metastatic perirectal lymph nodes (diameter > 5 mm) provided 79.2% diagnostic accuracy, 88.5% sensitivity, and 86.5% negative predictive value. This can be useful in those patients in whom prompt surgery, soon after radiochemotherapy in the case of nodal involvement, may likely be curative. With further improvement with spiral CT in local staging and nodal involvement, a larger number of transanal curative resections can be predicted.

Radio-Chemotherapy as a Preoperative Treatment for Advanced Rectal Cancer. Evaluation of Down-Staging and Morbidity

“…The complete remission rate was low (8.1% clinical and 8.0% pathological) as is to be expected for locally advanced tumor. The correlation between clinical and pathological staging is also confirmed and corresponds to the already known literature [12][13][14][15]. The most common form of acute toxicity encountered during adjuvant pelvic irradiation is diarrhea (approximately 24% of the patients).…”

“…The remaining 13 patients were operated in other hospitals and were not re-evaluated with CT and/or MRI. The following parameters were evaluated: (1) clinical remission after treatment, based upon CT and or MRI results [12][13][14][15]; (2) pathological remission after treatment based upon histological results after surgery; (3) complication rate caused by RCT; (4) postoperative morbidity. No evaluation of survival rate was done due to the short follow-up time.…”

“…Histological grading was rated G2 in 42 patients, G3 in 6 patients, and high-grade dysplasia in 2 patients. Staging was based on computed tomography (CT), magnetic resonance imaging (MRI) and endosonography [12][13][14][15]. Biopsies were taken during coloscopic control.…”

“…They differ, however, regarding the application modes and chemotherapy doses. The pretreatment diagnosis is generally based on computed tomography (CT) [12], magnetic resonance imaging (MRI) [13,14] or ultrasound (US) [15]. The effectiveness of MRI in comparison to CT has previously been demonstrated [14].…”

Total Mesorectal Excision, Lateral Lymphadenectomy and Autonomic Nerve Preservation for Lower Rectal Cancer: Significance in the Long-term Follow-up Study.

“…Although only a handful of patients have LLN metastasis, LLA is unavoidable for some patients with advanced lower rectal cancer, because an accurate diagnosis for LLN metastasis cannot be made, even though using computed tomography and magnetic resonance imaging. Although Tada reported a unique and highly accurate diagnostic method for LLN metastasis using ultrasound [39], the accuracy is usually at 60-80% [40][41][42].…”