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Accuracy of endorectal ultrasonography and computed tomography for restaging rectal cancer after preoperative chemoradiation

Authors
 JungWook Huh  ;  Yoon Ah Park  ;  Eun Joo Jung  ;  Kang Young Lee  ;  Seung-Kook Sohn 
Citation
 JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, Vol.207(1) : 7-12, 2008 
Journal Title
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
ISSN
 1072-7515 
Issue Date
2008
MeSH
Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Lymphatic Metastasis/diagnosis ; Male ; Middle Aged ; Neoplasm Staging/methods* ; Preoperative Care ; Rectal Neoplasms/diagnostic imaging* ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Rectum ; Tomography, X-Ray Computed* ; Ultrasonography/methods
Keywords
Adult ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Lymphatic Metastasis/diagnosis ; Male ; Middle Aged ; Neoplasm Staging/methods* ; Preoperative Care ; Rectal Neoplasms/diagnostic imaging* ; Rectal Neoplasms/pathology ; Rectal Neoplasms/therapy ; Rectum ; Tomography, X-Ray Computed* ; Ultrasonography/methods
Abstract
BACKGROUND: Preoperative restaging of irradiated rectal cancer is essential for the planning of optimal therapy. The aim of this study was to compare the accuracy of endorectal ultrasonography (ERUS) and CT in restaging rectal cancer after preoperative chemoradiation and to evaluate the factors affecting the accuracy of ERUS. STUDY DESIGN: Eighty-three patients with initial, locally advanced rectal cancer were prospectively evaluated by ERUS (n=60) and CT (n=80) after preoperative chemoradiation and just before surgery. All patients then underwent subsequent surgical resection and complete pathologic staging. RESULTS: In restaging the depth of invasion, the overall accuracy was 38.3% (23 of 60) by ERUS and 46.3% (37 of 80) by CT. Overstaging was more common than understaging with both imaging modalities. Accuracy for restaging lymph node metastasis was 72.6% (37 of 51) by ERUS and 70.4% (50 of 71) by CT. The predictive value of node-negative cases by ERUS was somewhat lower than that of CT (81.1% versus 85.4%, respectively). Complete pathology-proved remission was not correctly predicted in any of the 11 patients by any imaging modalities. Pathologic T and N staging correlated with the staging accuracy of ERUS (p=0.028 and p=0.001, respectively). CONCLUSIONS: ERUS and CT may allow good prediction of node-negative rectal cancers, although they are inaccurate modalities for predicting treatment response on the rectal wall. New methods of interpretation and diagnostic criteria for ERUS and CT are essential for increasing the accuracy of cancer prediction in at-risk patients.
Full Text
http://www.sciencedirect.com/science/article/pii/S1072751508000173
DOI
10.1016/j.jamcollsurg.2008.01.002
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Yoon Ah(박윤아)
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
Jung, Eun Joo(정은주) ORCID logo https://orcid.org/0000-0002-8297-0611
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107303
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