Skip to main content
Erschienen in: Langenbeck's Archives of Surgery 5/2006

01.09.2006 | Original article

Preoperative evaluation of pelvic lateral lymph node of patients with lower rectal cancer: comparison study of MR imaging and CT in 53 patients

verfasst von: Kazuo Arii, Katsunari Takifuji, Shozo Yokoyama, Kenji Matsuda, Takashi Higashiguchi, Toshiji Tominaga, Yoshimasa Oku, Masaji Tani, Hiroki Yamaue

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 5/2006

Einloggen, um Zugang zu erhalten

Abstract

Background

Preoperative assessment of the lateral pelvic lymph nodes is important for treatment strategy to patients with lower rectal cancer.

Materials and methods

Fifty-three patients with primary lower rectal cancer were preoperatively assessed by spiral computed tomography (CT) and magnetic resonance imaging (MRI) at 1.5 T with a phased-array coil. Preoperative tumor and lymph node stages were compared with the final histological findings.

Results

The MRI tumor stage coincided with the histological stage in 36 of 53 patients (68%). The MRI and CT lymph node stage coincided with the histological stage in 33 (62%) and 26 (49%) of 53 patients, respectively. However the accuracy of MRI in detecting the lateral pelvic lymph node involvement was 83%, compared to 77% of CT (p<0.05).

Conclusions

With the use of MRI, the lateral pelvic lymph node involvement can be predicted with high accuracy, allowing preoperative identification of patients who need radiotherapy or extensive surgery to escape recurrence.
Literatur
1.
Zurück zum Zitat Sagar PM, Pemberton JH (1996) Surgical management of locally recurrent rectal cancer. Br J Surg 83:293–304PubMedCrossRef Sagar PM, Pemberton JH (1996) Surgical management of locally recurrent rectal cancer. Br J Surg 83:293–304PubMedCrossRef
2.
Zurück zum Zitat Adam IJ, Mohamdee MO, Martin IG, Scott N, Finan PJ, Johnston D, Dixon MF, Quirke P et al (1994) Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet 344:707–711PubMedCrossRef Adam IJ, Mohamdee MO, Martin IG, Scott N, Finan PJ, Johnston D, Dixon MF, Quirke P et al (1994) Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet 344:707–711PubMedCrossRef
3.
Zurück zum Zitat de Haas-Kock DF, Baeten CG, Jager JJ, Langendijk JA, Schouten LJ, Volovics A, Arends JW (1996) Prognostic significance of radial margins of clearance in rectal cancer. Br J Surg 83:781–785PubMedCrossRef de Haas-Kock DF, Baeten CG, Jager JJ, Langendijk JA, Schouten LJ, Volovics A, Arends JW (1996) Prognostic significance of radial margins of clearance in rectal cancer. Br J Surg 83:781–785PubMedCrossRef
4.
Zurück zum Zitat Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 2:996–999PubMedCrossRef Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 2:996–999PubMedCrossRef
5.
Zurück zum Zitat Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1:1479–1482PubMedCrossRef Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1:1479–1482PubMedCrossRef
6.
Zurück zum Zitat MacFarlane JK, Ryall RD, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet 341:457–460PubMedCrossRef MacFarlane JK, Ryall RD, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet 341:457–460PubMedCrossRef
7.
Zurück zum Zitat Mori T, Takahashi K, Yasuno M (1998) Radical resection with autonomic nerve preservation and lymph node dissection techniques in lower rectal cancer surgery and its results: the impact of lateral lymph node dissection. Langenbecks Arch Surg 383:409–415PubMedCrossRef Mori T, Takahashi K, Yasuno M (1998) Radical resection with autonomic nerve preservation and lymph node dissection techniques in lower rectal cancer surgery and its results: the impact of lateral lymph node dissection. Langenbecks Arch Surg 383:409–415PubMedCrossRef
8.
Zurück zum Zitat Swedish Rectal Cancer Trial investigators (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987CrossRef Swedish Rectal Cancer Trial investigators (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987CrossRef
9.
Zurück zum Zitat No authors listed (1990) NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA 264:1444–1450 No authors listed (1990) NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA 264:1444–1450
10.
Zurück zum Zitat Hulsmans FJ, Tio TL, Fockens P, Bosma A, Tytgat GN (1994) Assessment of tumor infiltration depth in rectal cancer with transrectal sonography: caution is necessary. Radiology 190:715–720PubMed Hulsmans FJ, Tio TL, Fockens P, Bosma A, Tytgat GN (1994) Assessment of tumor infiltration depth in rectal cancer with transrectal sonography: caution is necessary. Radiology 190:715–720PubMed
11.
Zurück zum Zitat Holdsworth PJ, Johnston D, Chalmers AG, Chennells P, Dixon MF, Finan PJ, Primrose JN, Quirke P (1988) Endoluminal ultrasound and computed tomography in the staging of rectal cancer. Br J Surg 75:1019–1022PubMedCrossRef Holdsworth PJ, Johnston D, Chalmers AG, Chennells P, Dixon MF, Finan PJ, Primrose JN, Quirke P (1988) Endoluminal ultrasound and computed tomography in the staging of rectal cancer. Br J Surg 75:1019–1022PubMedCrossRef
12.
Zurück zum Zitat Kim NK, Kim MJ, Yun SH, Sohn SK, Min JS (1999) Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum 42:770–775PubMedCrossRef Kim NK, Kim MJ, Yun SH, Sohn SK, Min JS (1999) Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum 42:770–775PubMedCrossRef
13.
Zurück zum Zitat Hodgman CG, MacCarty RL, Wolff BG, May GR, Berquist TH, Sheedy PF 2nd, Beart RW Jr, Spencer RJ (1986) Preoperative staging of rectal carcinoma by computed tomography and 0.15 T magnetic resonance imaging: preliminary report. Dis Colon Rectum 29:446–450PubMedCrossRef Hodgman CG, MacCarty RL, Wolff BG, May GR, Berquist TH, Sheedy PF 2nd, Beart RW Jr, Spencer RJ (1986) Preoperative staging of rectal carcinoma by computed tomography and 0.15 T magnetic resonance imaging: preliminary report. Dis Colon Rectum 29:446–450PubMedCrossRef
14.
Zurück zum Zitat Butch RJ, Stark DD, Wittenberg J, Tepper JE, Saini S, Simeone JF, Mueller PR, Ferrucci JT Jr (1986) Staging rectal cancer by MR and CT. AJR Am J Roentgenol 146:1155–1160PubMed Butch RJ, Stark DD, Wittenberg J, Tepper JE, Saini S, Simeone JF, Mueller PR, Ferrucci JT Jr (1986) Staging rectal cancer by MR and CT. AJR Am J Roentgenol 146:1155–1160PubMed
15.
Zurück zum Zitat Hadfield MB, Nicholson AA, MacDonald AW, Farouk R, Lee PW, Duthie GS, Monson JR (1997) Preoperative staging of rectal carcinoma by magnetic resonance imaging with a pelvic phased-array coil. Br J Surg 84:529–531PubMedCrossRef Hadfield MB, Nicholson AA, MacDonald AW, Farouk R, Lee PW, Duthie GS, Monson JR (1997) Preoperative staging of rectal carcinoma by magnetic resonance imaging with a pelvic phased-array coil. Br J Surg 84:529–531PubMedCrossRef
16.
Zurück zum Zitat Schnall MD, Furth EE, Rosato EF, Kressel HY (1994) Rectal tumor stage: correlation of endorectal MR imaging and pathologic findings. Radiology 190:709–714PubMed Schnall MD, Furth EE, Rosato EF, Kressel HY (1994) Rectal tumor stage: correlation of endorectal MR imaging and pathologic findings. Radiology 190:709–714PubMed
17.
Zurück zum Zitat Brown G, Richards CJ, Newcombe RG, Dallimore NS, Radcliffe AG, Carey DP, Bourne MW, Williams GT (1999) Rectal carcinoma: thin-section MR imaging for staging in 28 patients. Radiology 211:215–222PubMed Brown G, Richards CJ, Newcombe RG, Dallimore NS, Radcliffe AG, Carey DP, Bourne MW, Williams GT (1999) Rectal carcinoma: thin-section MR imaging for staging in 28 patients. Radiology 211:215–222PubMed
18.
Zurück zum Zitat Heriot AG, Grundy A, Kumar D (1999) Preoperative staging of rectal carcinoma. Br J Surg 86:17–28PubMedCrossRef Heriot AG, Grundy A, Kumar D (1999) Preoperative staging of rectal carcinoma. Br J Surg 86:17–28PubMedCrossRef
20.
Zurück zum Zitat Phillips RK, Hittinger R, Blesovsky L, Fry JS, Fielding LP (1984) Local recurrence following ‘curative’ surgery for large bowel cancer: I. The overall picture. Br J Surg 71:12–16PubMedCrossRef Phillips RK, Hittinger R, Blesovsky L, Fry JS, Fielding LP (1984) Local recurrence following ‘curative’ surgery for large bowel cancer: I. The overall picture. Br J Surg 71:12–16PubMedCrossRef
21.
Zurück zum Zitat Cawthorm SJ, Parums DV, Gibbs NM, A’Hern RP, Caffarey SM, Broughton CI, Marks CG (1990) Extent of mesorectal spread and involvement of lateral resection margin as prognostic factors after surgery for rectal cancer. Lancet 335:1055–1059CrossRef Cawthorm SJ, Parums DV, Gibbs NM, A’Hern RP, Caffarey SM, Broughton CI, Marks CG (1990) Extent of mesorectal spread and involvement of lateral resection margin as prognostic factors after surgery for rectal cancer. Lancet 335:1055–1059CrossRef
22.
Zurück zum Zitat Balthazar EJ, Megibow AJ, Hulnick D, Naidich DP (1988) Carcinoma of the colon: detection and preoperative staging by CT. AJR Am J Roentgenol 150:301–306PubMed Balthazar EJ, Megibow AJ, Hulnick D, Naidich DP (1988) Carcinoma of the colon: detection and preoperative staging by CT. AJR Am J Roentgenol 150:301–306PubMed
23.
Zurück zum Zitat Thompson WM, Halvorsen RA, Foster WL Jr, Roberts L, Gibbons R (1986) Preoperative and postoperative CT staging of rectosigmoid carcinoma. AJR Am J Roentgenol 146:703–710PubMed Thompson WM, Halvorsen RA, Foster WL Jr, Roberts L, Gibbons R (1986) Preoperative and postoperative CT staging of rectosigmoid carcinoma. AJR Am J Roentgenol 146:703–710PubMed
24.
Zurück zum Zitat Guinet C, Buy JN, Ghossain MA, Sezeur A, Mallet A, Bigot JM, Vadrot D, Ecoiffier J (1990) Comparison of magnetic resonance imaging and computed tomography in the preoperative staging of rectal cancer. Arch Surg 125:385–388PubMed Guinet C, Buy JN, Ghossain MA, Sezeur A, Mallet A, Bigot JM, Vadrot D, Ecoiffier J (1990) Comparison of magnetic resonance imaging and computed tomography in the preoperative staging of rectal cancer. Arch Surg 125:385–388PubMed
25.
Zurück zum Zitat Shank B, Dershaw DD, Caravelli J, Barth J, Enker W (1990) A prospective study of the accuracy of preoperative computed tomographic staging of patients with biopsy-proven rectal carcinoma. Dis Colon Rectum 33:285–290PubMedCrossRef Shank B, Dershaw DD, Caravelli J, Barth J, Enker W (1990) A prospective study of the accuracy of preoperative computed tomographic staging of patients with biopsy-proven rectal carcinoma. Dis Colon Rectum 33:285–290PubMedCrossRef
26.
Zurück zum Zitat de Lange EE, Fechner RE, Edge SB, Spaulding CA (1990) Preoperative staging of rectal carcinoma with MR imaging: surgical and histopathologic correlation. Radiology 176:623–628PubMed de Lange EE, Fechner RE, Edge SB, Spaulding CA (1990) Preoperative staging of rectal carcinoma with MR imaging: surgical and histopathologic correlation. Radiology 176:623–628PubMed
27.
Zurück zum Zitat Waizer A, Powsner E, Russo I, Hadar S, Cytron S, Lombrozo R, Wolloch Y, Antebi E (1991) Prospective comparative study of magnetic resonance imaging versus transrectal ultrasound for preoperative staging and follow-up of rectal cancer. Preliminary report. Dis Colon Rectum 34:1068–1072PubMedCrossRef Waizer A, Powsner E, Russo I, Hadar S, Cytron S, Lombrozo R, Wolloch Y, Antebi E (1991) Prospective comparative study of magnetic resonance imaging versus transrectal ultrasound for preoperative staging and follow-up of rectal cancer. Preliminary report. Dis Colon Rectum 34:1068–1072PubMedCrossRef
28.
Zurück zum Zitat McNicholas MM, Joyce WP, Dolan J, Gibney RG, MacErlaine DP, Hyland J (1994) Magnetic resonance imaging of rectal carcinoma: a prospective study. Br J Surg 81:911–914PubMedCrossRef McNicholas MM, Joyce WP, Dolan J, Gibney RG, MacErlaine DP, Hyland J (1994) Magnetic resonance imaging of rectal carcinoma: a prospective study. Br J Surg 81:911–914PubMedCrossRef
29.
Zurück zum Zitat Thaler W, Watzka S, Martin F, La Guardia G, Psenner K, Bonatti G, Fichtel G, Egarter-Vigl E, Marzoli GP (1994) Preoperative staging of rectal cancer by endoluminal ultrasound vs. magnetic resonance imaging. Preliminary results of a prospective, comparative study. Dis Colon Rectum 37:1189–1193PubMedCrossRef Thaler W, Watzka S, Martin F, La Guardia G, Psenner K, Bonatti G, Fichtel G, Egarter-Vigl E, Marzoli GP (1994) Preoperative staging of rectal cancer by endoluminal ultrasound vs. magnetic resonance imaging. Preliminary results of a prospective, comparative study. Dis Colon Rectum 37:1189–1193PubMedCrossRef
30.
Zurück zum Zitat Kusunoki M, Yanagi H, Kamikonya N, Hishikawa Y, Shoji Y, Yamamura T, Utsunomiya J (1994) Preoperative detection of local extension of carcinoma of the rectum using magnetic resonance imaging. J Am Coll Surg 179:653–656PubMed Kusunoki M, Yanagi H, Kamikonya N, Hishikawa Y, Shoji Y, Yamamura T, Utsunomiya J (1994) Preoperative detection of local extension of carcinoma of the rectum using magnetic resonance imaging. J Am Coll Surg 179:653–656PubMed
31.
Zurück zum Zitat Nagtegaal ID, Marijnen CA, Kranenbarg EK, van de Velde CJ, van Krieken JH, Pathology Review Committee, Cooperative Clinical Investigators (2002) Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma: not one millimeter but two millimeters is the limit. Am J Surg Pathol 26:350–357PubMedCrossRef Nagtegaal ID, Marijnen CA, Kranenbarg EK, van de Velde CJ, van Krieken JH, Pathology Review Committee, Cooperative Clinical Investigators (2002) Circumferential margin involvement is still an important predictor of local recurrence in rectal carcinoma: not one millimeter but two millimeters is the limit. Am J Surg Pathol 26:350–357PubMedCrossRef
Metadaten
Titel
Preoperative evaluation of pelvic lateral lymph node of patients with lower rectal cancer: comparison study of MR imaging and CT in 53 patients
verfasst von
Kazuo Arii
Katsunari Takifuji
Shozo Yokoyama
Kenji Matsuda
Takashi Higashiguchi
Toshiji Tominaga
Yoshimasa Oku
Masaji Tani
Hiroki Yamaue
Publikationsdatum
01.09.2006
Verlag
Springer-Verlag
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 5/2006
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-006-0066-0

Weitere Artikel der Ausgabe 5/2006

Langenbeck's Archives of Surgery 5/2006 Zur Ausgabe

Mastery in Surgery

Dr. Wilhelm Heim

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Was nützt die Kraniektomie bei schwerer tiefer Hirnblutung?

17.05.2024 Hirnblutung Nachrichten

Eine Studie zum Nutzen der druckentlastenden Kraniektomie nach schwerer tiefer supratentorieller Hirnblutung deutet einen Nutzen der Operation an. Für überlebende Patienten ist das dennoch nur eine bedingt gute Nachricht.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.