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Clin Colon Rectal Surg 2002; 15(1): 017-026
DOI: 10.1055/s-2002-23564
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Preoperative Staging of Rectal Cancer

David E. Rivadeneira1 , W. Douglas Wong1, 2
  • 1Department of Surgery, New York Presbyterian Hospital-Cornell University Medical College
  • 2Division of Colorectal Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
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Publication History

Publication Date:
03 April 2002 (online)

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ABSTRACT

Advancements in surgical techniques and equipment, combined with the increasing use of preoperative radiation, have made sphincter-saving procedures increasingly available to patients with rectal cancer. The accurate preoperative local staging of rectal cancer, including tumor depth penetration and regional lymph node metastases, is essential in determining the most appropriate therapeutic option available and provides valuable information on prognosis in patients with rectal cancer. Although several imaging modalities such as computed tomography and magnetic resonance imaging are available for the local staging of rectal tumors, endoscopic rectal ultrasound remains the modality of choice. It provides accurate assessment of tumor penetration into the rectal wall and information on regional lymph node staging in the majority of patients. This article will review the current modalities used for the preoperative staging of patients with rectal cancer, with emphasis on the use of endorectal ultrasound.

KEYWORD

Rectal cancer - endorectal ultrasound - staging - computed tomography - magnetic resonance imaging

REFERENCES

  • 1 Jemal A, Thomas A, Murray T, Thun M. Cancer statistics, 2002.  CA Cancer J Clin . 2002;  52 23-47
    CrossrefPubMedSearch in Google Scholar
  • 2 Duke C. The classification of cancer of the rectum.  J Path Bacteriol . 1932;  35 323-332
    PubMedSearch in Google Scholar
  • 3 Kirklin J, Dockerty M, Waugh J. The role of the peritoneal reflection in the prognosis of carcinoma of the rectum and sigmoid colon.  Surg Gynecol Obstet . 1949;  88 326-331
    PubMedSearch in Google Scholar
  • 4 Astler V, Collier F. The prognostic significance of direct extension of carcinoma of the colon and rectum.  Ann Surg . 1954;  139 846-851
    PubMedSearch in Google Scholar
  • 5 American Joint Committee on Cancer. AJCC Cancer Staging Manual.  5th ed. Chicago: AJCC; 1997
    Search in Google Scholar
  • 6 Mason A. Rectal cancer: the spectrum of selective surgery.  Proc R Soc Med . 1976;  69 237-244
    PubMedSearch in Google Scholar
  • 7 Nicholls R, Mason A, Morson B. The clinical staging of rectal cancer.  Br J Surg . 1982;  69 404-409
    PubMedSearch in Google Scholar
  • 8 Rifkin M, Ehrlich S, Marks G. Staging of rectal carcinoma: prospective comparison of endorectal US and CT.  Radiology . 1989;  170 319-322
    PubMedSearch in Google Scholar
  • 9 Goldman S. Transrectal ultrasound and computed tomography in preoperative staging of lower rectal adenocarcinoma.  Gastrointest Radiol . 1991;  16 259-263
    CrossrefPubMedSearch in Google Scholar
  • 10 Blomqvist L, Holm T, Rubio C. Rectal tumour staging: MR imaging using pelvic phased-array and endorectal coils vs endoscopic ultrasonography.  Eur Radiol . 2000;  10 653-660
    CrossrefPubMedSearch in Google Scholar
  • 11 Thaler W, Watzka S, Martin F. Preoperative staging of rectal cancer by endoluminal ultrasound vs magnetic resonance imaging: preliminary results of a prospective comparative study.  Dis Colon Rectum . 1994;  37 1189-1193
    CrossrefPubMedSearch in Google Scholar
  • 12 Guillem J, Puig-La Calle J, Akhurst T. Prospective assessment of primary rectal cancer response to preoperative radiation and chemotherapy using 18-flurodeoxyglucose positron emission tomography.  Dis Colon Rectum . 2000;  43 18-24
    PubMedSearch in Google Scholar
  • 13 Boykin K. The use of FDG-positron emission tomography for the evaluation of colorectal metastases of the liver.  Am Surg . 1999;  65 1183-1185
    PubMedSearch in Google Scholar
  • 14 Bernick P, Wong W D. Staging: What makes sense?.  <~>Can the pathologist help? Surg Oncol Clin N Amer . 2000;  9 703-720
    PubMedSearch in Google Scholar
  • 15 Akasu T, Kondo H, Moriya Y. Endorectal ultrasonography and treatment of early stage rectal cancer.  World J Surg . 2000;  24 1061-1068
    CrossrefPubMedSearch in Google Scholar
  • 16 Wong W, Orrom W, Jensen L. Preoperative staging of rectal cancer with endorectal ultrasonography.  Perspectives Colon Rectal Surg . 1990;  3 315-334
    PubMedSearch in Google Scholar
  • 17 Stoker J, Rociu E, Wiersma T G. Imaging of anorectal disease.  Br J Surg . 2000;  87 10-27
    CrossrefPubMedSearch in Google Scholar
  • 18 Solomon M, McLeod R. Endoluminal transrectal ultrasonography: accuracy, reliability, and validity.  Dis Colon Rectum . 1993;  36 200-205
    PubMedSearch in Google Scholar
  • 19 Saclarides T. Surgeon-performed ultrasound.  Surg Clin N Amer . 1998;  78 237-250
    PubMedSearch in Google Scholar
  • 20 Mason A. Role of local surgery in carcinoma of the rectum.  Proc R Soc Med . 1976;  69 869-872
    PubMedSearch in Google Scholar
  • 21 Holdsworth P J, Johnston D, Chalmers A G. Endoluminal ultrasound and computed tomography in the staging of rectal cancer.  Br J Surg . 1988;  75 1019-1022
    PubMedSearch in Google Scholar
  • 22 Beynon J, Foy D M, Temple L N. The endoscopic appearances of normal colon and rectum.  Dis Colon Rectum . 1986;  28 810-813
    PubMedSearch in Google Scholar
  • 23 Kim H, Wong W D. Role of endorectal ultrasound in the conservative management of rectal cancers.  Semin Surg Oncol . 2000;  19 358-366
    CrossrefPubMedSearch in Google Scholar
  • 24 Waizer A, Powsner E, Russo I. Comparative study for preoperative staging of rectal cancer.  Dis Colon Rectum . 1989;  32 53-56
    CrossrefPubMedSearch in Google Scholar
  • 25 Kim N K, Kim M J, Yun S H. Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer.  Dis Colon Rectum . 1999;  42 770-775
    CrossrefPubMedSearch in Google Scholar
  • 26 Osti M, Padovan F S, Pirolli C. Comparison between transrectal ultrasonography and computed tomography with rectal inflation of gas in preoperative staging of lower rectal cancer.  Eur Radiol . 1997;  7 26-30
    CrossrefPubMedSearch in Google Scholar
  • 27 Herzog U, Von Flue M, Tondelli P. How accurate is endorectal ultrasound in the preoperative staging of rectal cancer?.  Dis Colon Rectum . 1993;  36 127-134
    CrossrefPubMedSearch in Google Scholar
  • 28 Rivadeneira D E, Daly J M. Hepatic metastases in surgical oncology: contemporary principles and practice. Bland K, Daly J, Karakousis C, eds. New York: McGraw Hill 2000 : 1133-1147
    Search in Google Scholar
  • 29 Starck M, Bohe M, Fork F T. Endoluminal ultrasound and low-field magnetic resonance imaging are superior to clinical examination in the preoperative staging of rectal cancer.  Eur J Surg . 1995;  161 841-845
    PubMedSearch in Google Scholar
  • 30 Meyenberger C, Huch-Boni R A, Bertschinger P. Endoscopic ultrasound and endorectal magnetic resonance imaging: a prospective, comparative study for preoperative staging and follow-up of rectal cancer.  Endoscopy . 1995;  27 469-479
    Thieme ConnectPubMedSearch in Google Scholar
  • 31 Gualdi G, Casciani E, Guadalaxara A. Local staging of rectal cancer with transrectal ultrasound and endorectal magnetic resonance imaging: comparison with histologic findings.  Dis Colon Rectum . 2000;  43 338-345
    CrossrefPubMedSearch in Google Scholar
  • 32 Hildebrandt U, Feifel G. Preoperative staging of rectal cancer by intrarectal ultrasound.  Dis Colon Rectum . 1985;  28 42-46
    PubMedSearch in Google Scholar
  • 33 Blumberg D, Paty P B, Picon A I. All patients with small intramural rectal cancers are at risk for lymph node metastasis.  Dis Colon Rectum . 1999;  42 881-885
    CrossrefPubMedSearch in Google Scholar
  • 34 Garcia-Aguilar J, Mellegren A, Sirivong P. Local excision of rectal cancer without adjuvant therapy.  Ann Surg . 2000;  231 345-351
    CrossrefPubMedSearch in Google Scholar
  • 35 Benyon J, Mortensen N JM, Foy D MA. Preoperative assessment of mesorectal lymph node involvement in rectal cancer.  Br J Surg . 1989;  76 276-279
    PubMedSearch in Google Scholar
  • 36 Sunouchi K. Limitation of endorectal ultrasonography: what does a low lesion more than 5 mm in size correspond to histologically?.  Dis Colon Rectum . 1998;  41 761-764
    PubMedSearch in Google Scholar
  • 37 Katsura Y. Endorectal ultrasonography for the assessment of wall invasion and lymph node metastasis in rectal cancer.  Dis Colon Rectum . 1992;  35 362-368
    PubMedSearch in Google Scholar
  • 38 Ogunbiyi O A, Flanagan F L, Dehdashti F. Detection of recurrent and metastatic colorectal cancer: comparison of positron emission tomography and computed tomography.  Ann Surg Oncol . 1997;  4 613-620
    PubMedSearch in Google Scholar
  • 39 Rafaelsen S, Kronborg O, Fenger C. Digital rectal examination and transrectal ultrasonography in staging of rectal cancer. A prospective, blind study.  Acta Radiol . 1994;  35 300-304
    PubMedSearch in Google Scholar
  • 40 Kwok H, Bissett I, Hill G. Preoperative staging of rectal cancer.  Int J Colorectal Dis . 2000;  15 9-20
    CrossrefPubMedSearch in Google Scholar
  • 41 Deen K, Madoff R D, Wong W D. Preoperative staging of rectal neoplasm with endorectal ultrasonography.  Sem Colon Rectum Surg . 1995;  6 78-85
    PubMedSearch in Google Scholar
  • 42 Pikarsky A, Wexner S, Lebensart P. The use of rectal ultrasound for the correct diagnosis and treatment of rectal villous tumors.  Am J Surg . 2000;  179 261-265
    CrossrefPubMedSearch in Google Scholar