Rectal Tumour Staging with Endorectal Ultrasound: Is There Any Difference between Western and Eastern European Countries?

Abstract

Background. Rectal tumour management depends highly on locoregional extension. Rectal endoscopic ultrasound (ERUS) is a good alternative to computed tomography and magnetic resonance imaging. However, in Hungary only a small amount of rectal tumours is examined with ERUS. Methods. Our retrospective study (2006–2012) evaluates the diagnostic accuracy of ERUS and compares the results, the first data from Central Europe, with those from Western Europe. The effect of neoadjuvant therapy, rectal probe type, and investigator's experience were also assessed. Results. 311 of the 647 ERUS assessed locoregional extension. Histological comparison was available in 177 cases: 67 patients underwent surgery alone; 110 received neoadjuvant chemoradiotherapy (CRT); ERUS preceded CRT in 77 and followed it in 33 patients. T-staging was accurate in 72% of primarily operated patients. N-staging was less accurate (62%). CRT impaired staging accuracy (64% and 59% for T- and N-staging). Rigid probes were more accurate (79%). At least 30 examinations are needed to master the technique. Conclusions. The sensitivity of ERUS complies with the literature. ERUS is easy to learn and more accurate in early stages but unnecessary for restaging after CRT. Staging accuracy is similar in Western and Central Europe, although the number of examinations should be increased.

Radiotherapy for Patients With Resected Tumor Deposit–Positive Colorectal Cancer: A Surveillance, Epidemiology, and End Results–Based Population Study

“…In fact, RT is given more commonly among rectal cancer patients than colon cancer patients, and there are variations in the type and sequence of surgery. 34 Thus, the true effect of RT on survival rates may be influenced by the tumor location. To eliminate the confounding effect of tumor location, we examined the OS and CSS rates overall as well as among colon and rectal cancers separately.…”

“…Based on previous literature, RT, age, sex, tumor location, grade, AJCC T, N, and M categories, and chemotherapy were considered as study prognostic factors in this study. 6,13,18,[28][29][30][31][32][33][34][35][36] All variables used in the study were dichotomized. Radiotherapy was considered as the main exposure variable, with nodal category (N1c versus N0) as the secondary exposure variable.…”

EFSUMB Recommendations for Gastrointestinal Ultrasound Part 3: Endorectal, Endoanal and Perineal Ultrasound

“…Flexible echoendoscopes may be advanced under visual control up to the level of the tumor and are able to pass through narrower lumens of stenosing tumors. Comparative studies between the 2 types of devices are currently limited and have shown contradictory results for rectal cancer staging 4 5 6 . Both types of probes (rigid and flexible) do have the possibility of examining the iliac lymph nodes at about 20–25 cm from the anal verge.…”

Endoscopic Ultrasound Elastography in the Assessment of Rectal Tumors: How Well Does It Work in Clinical Practice?

“…Therefore, both EUS and EUS-RTE are a good choice for diagnosis, especially in the case of mild and moderate rectal malignancies. For the staging of advanced lesions, other methods with higher sensitivity such as MRI are recommended [ 11 ]. The data and images obtained by SR-RTE can be considered complementary information obtained by conventional EUS [ 12 ].…”