Erschienen in:
01.07.2004 | Original article
The value of endosonographic rectal carcinoma staging in routine diagnostics: a 10-year analysis
verfasst von:
W. K. H. Kauer, L. Prantl, H. J. Dittler, J. R. Siewert
Erschienen in:
Surgical Endoscopy
|
Ausgabe 7/2004
Einloggen, um Zugang zu erhalten
Abstract
Background
Endosonography is currently the gold standard for the local staging of rectal carcinoma, but its accuracy varies from 62% to 91%. This study aimed to determine the accuracy of endosonography, to evaluate the interobserver variability, and to compare the performance of the 7.5-MHz and the 10-MHz ultrasound scanners.
Methods
Between 1990 and 2000, 458 patients with rectal cancer were included in the study. All the patients had undergone rectal endosonography with a 7.5-MHz scan (period 1: 1990–1996) or a 10-MHz scan (period 2: 1997–2000). Endosonographic staging was compared with pathologic staging.
Results
The overall rate for correctly classified patients was 69% with respect to the T category and 68% with respect to the N category. There was no difference between the two scanners. In terms of accuracy, the T3 category tumors were the most (86%) and the T4 tumors the least (36%) accurately classified. Overstaging of tumors (19%) was much more frequent than understaging (12%). A high interobserver variability of 61% to 77% was noted. For pT1 tumors, the 10-MHz scan was almost two times more accurate than the 7.5-MHz scan (71% vs 36%).
Conclusions
The accuracy of endosonographic staging of rectal carcinoma very much depends on the T category. A high-resolution scanner and an experienced examiner can help to ensure that endosonography remains an important tool in the staging process of patients with rectal carcinoma, especially early carcinoma.