Role of endoscopic ultrasonography in the loco-regional staging of patients with rectal cancer

Marone, P.; Bellis, Mario De; D’Angelo, Valentina; Delrio, Paolo; Passananti, Valentina; Girolamo, Elena Di; Rossi, Giovanni Battista; Rega, Daniela; Tracey, Maura C.; Tempesta, Alfonso

doi:10.4253/wjge.v7.i7.688

Cited by 43 publications

(34 citation statements)

References 82 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…stage, differentiation, location, margins of resection and dysplasia where applicable. Preoperative staging of the tumours has been performed with magnetic resonance imaging (MRI) of the rectum and endorectal ultrasound (EUS), which are proven to have high diagnostic accuracy when combined (21)(22)(23)(24). We have an established follow-up protocol for these patients with an intensive 5-year surveillance consisting of 6 monthly endoscopy, carcinoembryonic antigen (CEA), MRI scan and computed tomography (CT) scan for 3 years, which is altered to annual surveillance in years 4 and 5 (Table I).…”

Section: Methodsmentioning

confidence: 99%

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

Sideris

Moorhead

Díaz‐Cano

et al. 2016

View full text Add to dashboard Cite

Abstract. Background The method of local excision, that has recently, gained wider acceptance, in early rectal cancer, is transanal endoscopic microsurgery (TEMS). TEMS generally offers advantages in operative access and oncological clearance over transanal resection (TAR), but recently a number of similar logic techniques with various rectal ports for endoscopic excision of rectal tumours has been invented. Those methods are collectively named transanal minimal-invasive surgery (TAMIS) and for oncological purposes they share the same features of local excision as TEMS (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).TEMS is a minimally invasive technique that was introduced by Buess in the early 1980's (2). Through the new rectoscope with 3D binocular optic and the endoscopic instruments, it offers better access to proximal lesions with lower margin positivity and fragmentation and magnification of the operative field (2, 15). TEMS is a safe procedure that offers low complication rates and peri-operative morbidity (10.7%) (4). There have been multiple studies to suggest that TEMS is the operation of choice for rectal adenomas (1), retrorectal and submucosal rectal lesions (5). Furthermore, TEMS offers the advantage of not damaging the anorectal function (7).TEMS is indicated as a curative treatment for malignant neoplasms that are histologically confirmed as pT1 sm1 carcinomas, whereas T1 sm2-3 and T2 lesions are still under question (8). A number of studies have shown that TEMS can have comparable results with radical surgery (1,8,12,16) for rectal cancer.There has been concern about oncologic outcomes following TEMS (17). Some studies support that there is potentially a higher risk of local recurrence rate with TEMS (8,10,18). Efforts have been made to classify risk with morphological and histological criteria with better patients' selection (1, 6-9); however, the risk stratification remains 5315

show abstract

Section: Methodsmentioning

confidence: 99%

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

Sideris

Moorhead

Díaz‐Cano

et al. 2016

View full text Add to dashboard Cite

show abstract

“…This not only represents the high capacity of 3D-EUS to identify lymph nodes but also reinforces our option for not imposing a cut-off value for node diameter in order to classify it as metastasized. However, there is no consensus with regard to this matter (28,29). In fact, this trend to improved accuracy was also observed in other studies (12,17,30,31).…”

Section: Discussionmentioning

confidence: 65%

3D echoendoscopy and miniprobes for rectal cancer staging

Castro-Poças¹,

Dinis-Ribeiro²,

Rocha³

et al. 2018

Rev Esp Enferm Dig

View full text Add to dashboard Cite

show abstract

“…The performance of ERUS is operator dependent and limited in the presence of a stricture[20]. Therefore the determination of tumour thickness, the precise mesorectal fascial margin, the presence of extramural venous invasion provided by MRI facilitate patient selection for neoadjuvant chemoradiotherapy in an attempt to reduce local recurrence rates.…”

Section: No Surgerymentioning

confidence: 99%

Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery

Plummer

Leake

Albert

2017

WJGS

View full text Add to dashboard Cite

Over the last decade, with the acceptance of the need for improvements in the outcome of patients affected with rectal cancer, there has been a significant increase in the literature regarding treatment options available to patients affected by this disease. That treatment related decisions should be made at a high volume multidisciplinary tumor board, after pre-operative rectal magnetic resonance imaging and the importance of total mesorectal excision (TME) are accepted standard of care. More controversial is the emerging role for watchful waiting rather than radical surgery in complete pathologic responders, which may be appropriate in 20% of patients. Patients with early T1 rectal cancers and favorable pathologic features can be cured with local excision only, with transanal minimal invasive surgery (TAMIS) because of its versatility and almost universal availability of the necessary equipment and skillset in the average laparoscopic surgeon, emerging as the leading option. Recent trials have raised concerns about the oncologic outcomes of the standard “top-down” TME hence transanal TME (TaTME “bottom-up”) approach has gained popularity as an alternative. The challenges are many, with a dearth of evidence of the oncologic superiority in the long-term for any given option. However, this review highlights recent advances in the role of chemoradiation only for complete pathologic responders, TAMIS for highly selected early rectal cancer patients and TaTME as options to improve cure rates whilst maintaining quality of life in these patients, while we await the results of further definitive trials being currently conducted.

show abstract

Role of endoscopic ultrasonography in the loco-regional staging of patients with rectal cancer

Cited by 43 publications

References 82 publications

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

KRAS Mutant Status, p16 and β-catenin Expression May Predict Local Recurrence in Patients Who Underwent Transanal Endoscopic Microsurgery (TEMS) for Stage I Rectal Cancer

3D echoendoscopy and miniprobes for rectal cancer staging

Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery

Contact Info

Product

Resources

About