Accuracy of endorectal ultrasonography in staging locally advanced rectal cancer after preoperative chemoradiation
Accuracy of endorectal ultrasonography in staging locally advanced rectal cancer after preoperative chemoradiation
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DOI：
10.1007/s00464-008-0037-3
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发表时间：
2008-11-01
影响因子：
3.1
通讯作者：
Radovanovic, D.
中科院分区：
文献类型：
--
作者：
Radovanovic, Zoran;Breberina, M.;Radovanovic, D.
我们的研究的目的是确定准确性的直肠内超声（ERUS）在分期局部进展期直肠癌术前新辅助放化疗后，并指出最常见的原因，错误interpretation.Methods四十四例局部进展期直肠癌接受新辅助放化疗，然后根治性手术。结果ERUS对放化疗后T分期的准确率为75%（33/44），术前1-2周行ERUS分期，并与手术切除标本的病理组织学结果进行比较。18%（8/44）的患者发生过分期，7%（3/44）的患者发生过分期。大多数过度分期发生在ERUS T3肿瘤患者中，最终发现具有病理pT 0-pT 2分期。5例患者（11.4%）的组织学完全消退，其中只有1例患者的分期正确，而其他患者的分期过高。在直肠周围淋巴结转移的检测中，ERUS的准确率为68%（30/44）。20%（9/44）的患者分期过高，11%（5/44）的患者分期过低。然而，它是不够的，在检测完全的病理反应。
The aim of our study was to determine the accuracy of endorectal ultrasonography (ERUS) in staging locally advanced rectal cancer after preoperative neoadjuvant chemoradiation and to point out the most common reasons for false interpretation.Methods Forty-four patients with locally advanced rectal cancer received neoadjuvant chemoradiation followed by radical surgery. Restaging was done 1-2 weeks before surgery and the results of ERUS staging were compared with histopathology findings of the resected specimen.Results The accuracy of ERUS for T stage after chemoradiation was 75% (33/44). Overstaging occurred in 18% (8/44) of patients, and 7% (3/44) were understaged. The majority of overstaging occurred in patients with ERUS T3 tumors, eventually found to have pathological pT0-pT2 staging. Five patients (11.4%) had complete histology regression and only one of these patients was staged correctly while others were overstaged. In the detection of perirectal lymph node metastases, ERUS was accurate in 68% of patients (30/44). Twenty percent (9/44) of patients were overstaged and 11% were (5/44) understaged.Conclusions ERUS provides a good accuracy rate for staging rectal cancer after neoadjuvant chemoradiation. However, it is insuficient in detection of complete pathological response.