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International Journal of Colorectal Disease

Erschienen in:

01.09.2003 | Review

Rectal cancer: how accurate can imaging predict the T stage and the circumferential resection margin?

verfasst von: R. G. H. Beets-Tan, G. L. Beets

Erschienen in: International Journal of Colorectal Disease | Ausgabe 5/2003

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Abstract

Background

One of the concerns after rectal cancer surgery is the local recurrence rate. Randomized trials have shown that the best local control rate for rectal cancer patients overall is obtained by a short preoperative course of radiotherapy followed by a total mesorectal excision, but there are however subgroups of rectal cancer patients with varying risks of recurrences.

Discussion

At one end of the continuum are patients with stage I disease who are at very low risk of local recurrence. At the other end are the patients with locally advanced tumor who are at very high risk, and who would benefit from a more extensive neoadjuvant treatment schedule. This kind of differentiated treatment can be performed only when there is an accurate tool to identify preoperatively the different risk groups. There is recent evidence, suggesting that MRI can serve for this purpose, because it accurately predicts the tumor free circumferential resection margin at TME.

Conclusion

This article provides a literature review of the value of preoperative imaging in rectal cancer surgery.

Midgley R, Kerr D (1999) Colorectal cancer. Lancet 353:391–399PubMed

Sagar PM, Pemberton JH (1996) Surgical management of locally recurrent rectal cancer. Br J Surg 83:293–304PubMed

Adam IJ, Mohamdee MO, Martin IG, Scott N, Finan PJ, Johnston D, Dixon MF, Quirke P (1994) Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet 344:707–711PubMed

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 II:996–999

Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet I:1479–1482

Investigators Swedish Rectal Cancer Trial (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med 336:980–987 (erratum appears in 336:1539)

Kapiteijn E, Marijnen CA, Nagtegaal ID, Putter H, Steup WH, Wiggers T, Rutten HJ, Pahlman L, Glimelius B, van Krieken JH, Leer JW, van de Velde CJ (2001) Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N Engl J Med 345:638–646CrossRefPubMed

Colorectal Cancer Collaborative Group (2001) Adjuvant radiotherapy for rectal cancer: a systematic overview of 8,507 patients from 22 randomised trials. Lancet 358:1291–1304CrossRefPubMed

Rifkin MD, Ehrlich SM, Marks G (1989) Staging of rectal carcinoma: prospective comparison of endorectal US and CT. Radiology 170:319–322PubMed

10.

Beynon J, Foy DM, Roe AM, Temple LN, Mortensen NJ (1986) Endoluminal ultrasound in the assessment of local invasion in rectal cancer. Br J Surg 73:474–477PubMed

11.

Glaser F, Schlag P, Herfarth C (1990) Endorectal ultrasonography for the assessment of invasion of rectal tumours and lymph node involvement. Br J Surg 77:883–887PubMed

12.

Katsura Y, Yamada K, Ishizawa T, Yoshinaka H, Shimazu H (1992) Endorectal ultrasonography for the assessment of wall invasion and lymph node metastasis in rectal cancer. Dis Colon Rectum 35:362–368PubMed

13.

Herzog U, von Flue M, Tondelli P, Schuppisser JP (1993) How accurate is endorectal ultrasound in the preoperative staging of rectal cancer? Dis Colon Rectum 36:127–134PubMed

14.

Akasu T, Sugihara K, Moriya Y, Fujita S (1997) Limitations and pitfalls of transrectal ultrasonography for staging of rectal cancer. Dis Colon Rectum 40:S10–S15PubMed

15.

Milsom JW, Graffner H (1990) Intrarectal ultrasonography in rectal cancer staging and in the evaluation of pelvic disease. Clinical uses of intrarectal ultrasound. Ann Surg 212:602–606PubMed

16.

Lee P, Oyama K, Homer L, Sullivan E (1999) Effects of endorectal ultrasonography in the surgical management of rectal adenomas and carcinomas. Am J Surg 177:388–391CrossRefPubMed

17.

Garcia-Aguilar J, Pollack J, Lee SH, Hernandez de Anda E, Mellgren A, Wong WD, Finne CO, Rothenberger DA, Madoff RD (2002) Accuracy of endorectal ultrasonography in preoperative staging of rectal tumors. Dis Colon Rectum 45:10–15PubMed

18.

Genna M, Leopardi F, Valloncini E, Veraldi GF (2000) [Results of preoperative staging using endosonography in rectal cancer]. Minerva Chir 55:409–414PubMed

19.

Gualdi GF, Casciani E, Guadalaxara A, d'Orta C, Polettini E, Pappalardo G (2000) Local staging of rectal cancer with transrectal ultrasound and endorectal magnetic resonance imaging: comparison with histologic findings. Dis Colon Rectum 43:338–345PubMed

20.

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 42:770–775PubMed

21.

Massari M, De Simone M, Cioffi U, Rosso L, Chiarelli M, Gabrielli F (1998) Value and limits of endorectal ultrasonography for preoperative staging of rectal carcinoma. Surg Laparosc Endosc 8:438–444PubMed

22.

Sailer M, Leppert R, Kraemer M, Fuchs KH, Thiede A (1997) The value of endorectal ultrasound in the assessment of adenomas, T1- and T2-carcinomas. Int J Colorectal Dis 12:214–219CrossRefPubMed

23.

Marone P, Petrulio F, de Bellis M, Battista Rossi G, Tempesta A (2000) Role of endoscopic ultrasonography in the staging of rectal cancer: a retrospective study of 63 patients. J Clin Gastroenterol 30:420–424CrossRefPubMed

24.

Maldjian C, Smith R, Kilger A, Schnall M, Ginsberg G, Kochman M (2000) Endorectal surface coil MR imaging as a staging technique for rectal carcinoma: a comparison study to rectal endosonography. Abdom Imaging 25:75–80CrossRefPubMed

25.

Akasu T, Kondo H, Moriya Y, Sugihara K, Gotoda T, Fujita S, Muto T, Kakizoe T (2000) Endorectal ultrasonography and treatment of early stage rectal cancer. World J Surg 24:1061–108CrossRefPubMed

26.

Solomon MJ, McLeod RS (1993) Endoluminal transrectal ultrasonography: accuracy, reliability, and validity. Dis Colon Rectum 36:200–205PubMed

27.

Enck P, Heyer T, Gantke B, Schmidt WU, Schafer R, Frieling T, Haussinger D (1997) How reproducible are measures of the anal sphincter muscle diameter by endoanal ultrasound? Am J Gastroenterol 92:293–296PubMed

28.

Gold DM, Halligan S, Kmiot WA, Bartram CI (1999) Intraobserver and interobserver agreement in anal endosonography. Br J Surg 86:371–375CrossRefPubMed

29.

Solomon MJ, McLeod RS, Cohen EK, Simons ME, Wilson S (1994) Reliability and validity studies of endoluminal ultrasonography for anorectal disorders. Dis Colon Rectum 37:546–551PubMed

30.

Thoeni RF, Moss AA, Schnyder P, Margulis AR (1981) Detection and staging of primary rectal and rectosigmoid cancer by computed tomography. Radiology 141:135–138PubMed

31.

Zaunbauer W, Haertel M, Fuchs WA (1981) Computed tomography in carcinoma of the rectum. Gastrointest Radiol 6:79–84PubMed

32.

Moss AA (1989) Imaging of colorectal carcinoma. Radiology 170:308–310PubMed

33.

Thoeni RF (1997) Colorectal cancer. Radiologic staging. Radiol Clin North Am 35:457–485PubMed

34.

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

35.

Hodgman CG, MacCarty RL, Wolff BG, May GR, Berquist TH, Sheedy PFD, Beart RW Jr, Spencer RJ (1986) Preoperative staging of rectal carcinoma by computed tomography and 0.15T magnetic resonance imaging. Preliminary report. Dis Colon Rectum 29:446–450PubMed

36.

Kwok H, Bissett IP, Hill GL (2000) Preoperative staging of rectal cancer. Int J Colorectal Dis 15:9–20CrossRefPubMed

37.

Horton KM, Abrams RA, Fishman EK (2000) Spiral CT of colon cancer: imaging features and role in management. Radiographics 20:419–430PubMed

38.

Chiesura-Corona M, Muzzio PC, Giust G, Zuliani M, Pucciarelli S, Toppan P (2001) Rectal cancer: CT local staging with histopathologic correlation. Abdom Imaging 26:134–138CrossRefPubMed

39.

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

40.

Okizuka H, Sugimura K, Ishida T (1993) Preoperative local staging of rectal carcinoma with MR imaging and a rectal balloon. J Magn Reson Imaging 3:329–335PubMed

41.

Cova M, Frezza F, Pozzi-Mucelli RS, Ukmar M, Tarjan Z, Melato M, Bucconi S, Dalla Palma L (1994) [Computed tomography and magnetic resonance in the preoperative staging of the spread of rectal cancer. A correlation with the anatomicopathological aspects]. Radiol Med (Torino) 87:82–89

42.

Zerhouni EA, Rutter C, Hamilton SR, Balfe DM, Megibow AJ, Francis IR, Moss AA, Heiken JP, Tempany CM, Aisen AM, Weinreb JC, Gatsonis C, McNeil BJ (1996) CT and MR imaging in the staging of colorectal carcinoma: report of the Radiology Diagnostic Oncology Group II. Radiology 200:443–451PubMed

43.

Starck M, Bohe M, Fork FT, Lindstrom C, Sjoberg S (1995) Endoluminal ultrasound and low-field magnetic resonance imaging are superior to clinical examination in the preoperative staging of rectal cancer. Eur J Surg 161:841–845PubMed

44.

Vogl TJ, Pegios W, Hunerbein M, Mack MG, Schlag PM, Felix R (1998) Use and applications of MRI techniques in the diagnosis and staging of rectal lesions. Recent Results Cancer Res 146:35–47PubMed

45.

Chan TW, Kressel HY, Milestone B, Tomachefski J, Schnall M, Rosato E, Daly J (1991) Rectal carcinoma: staging at MR imaging with endorectal surface coil. Work in progress. Radiology 181:461–467PubMed

46.

Schnall MD, Furth EE, Rosato EF, Kressel HY (1994) Rectal tumor stage: correlation of endorectal MR imaging and pathologic findings. Radiology 190:709–714PubMed

47.

Indinnimeo M, Grasso RF, Cicchini C, Pavone P, Stazi A, Catalano C, Scipioni A, Fanelli F (1996) Endorectal magnetic resonance imaging in the preoperative staging of rectal tumors. Int Surg 81:419–422PubMed

48.

Zagoria RJ, Schlarb CA, Ott DJ, Bechtold RI, Wolfman NT, Scharling ES, Chen MY, Loggie BW (1997) Assessment of rectal tumor infiltration utilizing endorectal MR imaging and comparison with endoscopic rectal sonography. J Surg Oncol 64:312–317CrossRefPubMed

49.

Pegios W, Vogl J, Mack MG, Hunerbein M, Hintze H, Balzer JO, Lobeck H, Wust P, Schlag P, Felix R (1996) MRI diagnosis and staging of rectal carcinoma. Abdom Imaging 21:211–218CrossRefPubMed

50.

Vogl TJ, Pegios W, Mack MG, Hunerbein M, Hintze R, Adler A, Lobbeck H, Hammerstingl R, Wust P, Schlag P, Felix R (1997) Accuracy of staging rectal tumors with contrast-enhanced transrectal MR imaging. AJR Am J Roentgenol 168:1427–1434PubMed

51.

Souza NM de, Hall AS, Puni R, Gilderdale DJ, Young IR, Kmiot WA (1996) High resolution magnetic resonance imaging of the anal sphincter using a dedicated endoanal coil. Comparison of magnetic resonance imaging with surgical findings. Dis Colon Rectum 39:926–934PubMed

52.

Beets-Tan RG, Beets GL, van der Hoop AG, Borstlap AC, van Boven H, Rongen MJ, Baeten CG, van Engelshoven JM (1999) High-resolution magnetic resonance imaging of the anorectal region without an endocoil. Abdom Imaging 24:576–581CrossRefPubMed

53.

Beets-Tan RG, Morren GL, Beets GL, Kessels AG, el Naggar K, Lemaire E, Baeten CG, van Engelshoven JM (2001) Measurement of anal sphincter muscles: endoanal US, endoanal MR imaging, or phased-array MR imaging? A study with healthy volunteers. Radiology 220:81–89PubMed

54.

Beets-Tan RG, Beets GL, van der Hoop AG, Kessels AG, Vliegen RF, Baeten CG, van Engelshoven JM (2001) Preoperative MR imaging of anal fistulas: does it really help the surgeon? Radiology 218:75–84PubMed

55.

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

56.

Blomqvist L, Machado M, Rubio C, Gabrielsson N, Granqvist S, Goldman S, Holm T (2000) Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography. Eur Radiol 10:653–660CrossRefPubMed

57.

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 84:529–531PubMed

58.

Lange EE de, Fechner RE, Edge SB, Spaulding CA (1990) Preoperative staging of rectal carcinoma with MR imaging: surgical and histological correlation. Radiology 176:623–628PubMed

59.

Beets-Tan RG, Beets GL, Vliegen RF, Kessels AG, Van Boven H, De Bruine A, von Meyenfeldt MF, Baeten CG, van Engelshoven JM (2001) Accuracy of magnetic resonance imaging in prediction of tumour-free resection margin in rectal cancer surgery. Lancet 357:497–504CrossRefPubMed

60.

Blomqvist L, Holm T, Rubio C, Hindmarsh T (1997) Rectal tumours-MR imaging with endorectal and/or phased-array coils, and histopathological staging on giant sections. A comparative study. Acta Radiol 38:437–444PubMed

61.

Gagliardi G, Bayar S, Smith R, Salem RR (2002) Preoperative staging of rectal cancer using magnetic resonance imaging with external phase-arrayed coils. Arch Surg 137:447–451PubMed

62.

Meyenberger C, Huch Boni RA, Bertschinger P, Zala GF, Klotz HP, Krestin GP (1995) Endoscopic ultrasound and endorectal magnetic resonance imaging: a prospective, comparative study for preoperative staging and follow-up of rectal cancer. Endoscopy 27:469–479PubMed

63.

Quirke P, Dixon MF (1988) The prediction of local recurrence in rectal adenocarcinoma by histopathological examination. Int J Colorectal Dis 3:127–131PubMed

64.

Wibe A, Rendedal PR, Svensson E, Norstein J, Eide TJ, Myrvold HE, Soreide O (2002) Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer. Br J Surg 89:327–334CrossRefPubMed

65.

Nagtegaal ID, Marijnen CA, Kranenbarg EK, van De Velde CJ, van Krieken JH (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 26:350–357CrossRefPubMed

66.

Nelson H, Sargent DJ (2001) Refining multimodal therapy for rectal cancer. N Engl J Med 345:690–692CrossRefPubMed

67.

Radcliffe A, Brown G (2001) Will MRI provide maps of lines of excision for rectal cancer? Lancet 357:495–496CrossRefPubMed

68.

Grabbe E, Lierse W, Winkler R (1983) The perirectal fascia: morphology and use in staging of rectal carcinoma. Radiology 149:241–246PubMed

69.

Blomqvist L, Rubio C, Holm T, Machado M, Hindmarsh T (1999) Rectal adenocarcinoma: assessment of tumour involvement of the lateral resection margin by MRI of resected specimen. Br J Radiol 72:18–23PubMed

70.

Bissett IP, Fernando CC, Hough DM, Cowan BR, Chau KY, Young AA, Parry BR, Hill GL (2001) Identification of the fascia propria by magnetic resonance imaging and its relevance to preoperative assessment of rectal cancer. Dis Colon Rectum 44:259–265PubMed

Titel: Rectal cancer: how accurate can imaging predict the T stage and the circumferential resection margin?
verfasst von: R. G. H. Beets-Tan
G. L. Beets
Publikationsdatum: 01.09.2003
Verlag: Springer-Verlag
Erschienen in: International Journal of Colorectal Disease / Ausgabe 5/2003
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI: https://doi.org/10.1007/s00384-003-0480-5

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