BACKGROUND: Endoscopic ultrasound (EUS) has been shown to be a reliable tool for staging rectal cancer. Nevertheless, the accuracy of EUS after chemoradiation remains unclear; therefore the purpose of the present paper was to compare the accuracy of EUS staging for rectal cancer before and following chemoradiation. METHODS: Patients with rectal cancer undergoing EUS staging were stratified into two groups. Group I consisted of 66 patients who underwent surgery following EUS staging without preoperative chemoradiation. Group II consisted of 25 patients who had EUS evaluation following chemoradiation. The EUS staging was compared to surgical/pathological staging. RESULTS: The accuracy of the T staging for group I was 86% (57/66). Inaccurate staging was mainly associated with overstaging EUS T2 tumors. The accuracy of the N staging for group I was 71% (47/66). The accuracy of EUS for a composite T and N staging relevant to treatment decisions in group I was 91%. In group II, the accuracy of T and N staging was 72% (18/25) and 80% (20/25), respectively. Overstaging EUS T3 tumors accounted for most inaccurate staging. The EUS staging predicted post-chemoradiation T0N0 stage correctly in only 50% of cases. CONCLUSIONS: Preoperative staging of rectal cancer by EUS is a useful modality in determining the need for preoperative chemoradiation. The EUS T staging following chemoradiation appears to be less accurate. Detection of complete response may be insufficient for selecting patients for limited surgical intervention.
BACKGROUND: Endoscopic ultrasound (EUS) has been shown to be a reliable tool for staging rectal cancer. Nevertheless, the accuracy of EUS after chemoradiation remains unclear; therefore the purpose of the present paper was to compare the accuracy of EUS staging for rectal cancer before and following chemoradiation. METHODS:Patients with rectal cancer undergoing EUS staging were stratified into two groups. Group I consisted of 66 patients who underwent surgery following EUS staging without preoperative chemoradiation. Group II consisted of 25 patients who had EUS evaluation following chemoradiation. The EUS staging was compared to surgical/pathological staging. RESULTS: The accuracy of the T staging for group I was 86% (57/66). Inaccurate staging was mainly associated with overstaging EUS T2 tumors. The accuracy of the N staging for group I was 71% (47/66). The accuracy of EUS for a composite T and N staging relevant to treatment decisions in group I was 91%. In group II, the accuracy of T and N staging was 72% (18/25) and 80% (20/25), respectively. Overstaging EUS T3 tumors accounted for most inaccurate staging. The EUS staging predicted post-chemoradiation T0N0 stage correctly in only 50% of cases. CONCLUSIONS: Preoperative staging of rectal cancer by EUS is a useful modality in determining the need for preoperative chemoradiation. The EUS T staging following chemoradiation appears to be less accurate. Detection of complete response may be insufficient for selecting patients for limited surgical intervention.
Authors: Pietro Marone; Mario de Bellis; Valentina D'Angelo; Paolo Delrio; Valentina Passananti; Elena Di Girolamo; Giovanni Battista Rossi; Daniela Rega; Maura Claire Tracey; Alfonso Mario Tempesta Journal: World J Gastrointest Endosc Date: 2015-06-25
Authors: Daniel C Damin; Mário A Rosito; Paulo C Contu; Cláudio Tarta; Paulo R Ferreira; Lucia M Kliemann; Gilberto Schwartsmann Journal: J Gastrointest Surg Date: 2012-05-23 Impact factor: 3.452
Authors: Srinivas R Puli; Matthew L Bechtold; Jyotsna B K Reddy; Abhishek Choudhary; Mainor R Antillon Journal: Dig Dis Sci Date: 2009-06-11 Impact factor: 3.199
Authors: Gianni Mezzi; Paolo Giorgio Arcidiacono; Silvia Carrara; Francesco Perri; Maria Chiara Petrone; Francesco De Cobelli; Simone Gusmini; Carlo Staudacher; Alessandro Del Maschio; Pier Alberto Testoni Journal: World J Gastroenterol Date: 2009-11-28 Impact factor: 5.742