Role of Endoscopic Ultrasonography in the Staging of Rectal Cancer

Abstract

We evaluated retrospectively the accuracy of endoscopic ultrasonography (EUS) in the preoperative staging of 63 patients with rectal cancer who were hospitalized and underwent surgery at our institution from January 1994 to December 1997. These patients, 39 men and 24 women with a mean age of 60 years, underwent preoperative EUS, which was performed in all cases using an echo-colonoscope Olympus CF UM 20, with a 7.5 MHz radial scanner. Ten patients did not undergo surgery and, therefore, were excluded from the analysis. EUS showed an overall accuracy of 81% for the T stage (including nontraversable stenotic tumors) and of 70% for the N stage. The accuracy of EUS for the T stage increased from 81 to 90% when we excluded those cases with nontraversable stenotic cancers from the analysis. Five tumors (9.4%) were understaged. while another five cases (9.4%) were overstaged. Finally, EUS was highly accurate (81%) in differentiating T1 from T24 tumors. In conclusion, our data shows that EUS is very accurate in the locoregional staging of rectal cancer and confirms the role of this imaging technique in the preoperative staging of patients with rectal cancer.

Application of Endoscopic Sonography in Preoperative Staging of Rectal Cancer

“…6,22 Some authors suggested that any visible perirectal lymph node should be considered metastatic. 13,30,31 This strategy may lead to a false-positive diagnosis of reactive lymph nodes, which eventually may cause overstaging. Therefore, better-defined criteria for sonographic N staging of rectal cancer are needed.…”

“…Several studies have shown good accuracy for endoscopic sonography in rectal cancer staging. 3,4,7,8,13 These studies showed that the overall accuracy of T staging fluctuated from 72% to 90%, and the overall accuracy of N staging ranged from 69% to 80%.Shiyong Lin, PhD, Guangyu Luo, MD, Xiaoyan Gao, Hongbo Shan, MD, Yin Li, MD, Rong Zhang, MD, Jianjun Li, MD, Longjun He, PhD, Guobao Wang, PhD, Guoliang Xu, MD Received January 20, 2011, …”

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

“…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].…”

“…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]. The objective of our current study is to evaluate down-staging and morbidity in the preoperative treatment of locoregionally advanced, rectal cancer with combined radio-and chemotherapy.…”

Changing Trends in Endosonography: Linear Imaging and Tissue are Increasingly the Issue

“…In this single-center experience, EUS has shifted from an imaging technology to an image-guided biopsy and therapeutic technology. The use of the linear array EUS alone has increased, especially in the evaluation of pancreatobiliary and mediastinal disease and when fine-needle aspiration is performed.Endoscopic ultrasound (EUS) has emerged as an important tool for the evaluation of gastrointestinal disorders [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Fine needle aspiration (FNA), which requires the use of the linear array EUS, has taken an increasingly important role in the diagnosis and staging of gastrointestinal and mediastinal malignancies [5,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34].…”