Die Bedeutung der Endosonografie im Staging des Rektumkarzinoms

Zusammenfassung

Für eine zeitgemäße Therapie des Rektumkarzinoms ist eine differenzierte präinterventionelle Diagnostik unerlässlich. Sie entscheidet über die Indikation zur neoadjuvanten Therapie und beeinflusst die Wahl des Operationsverfahrens. Der endoskopische Ultraschall ist etablierter Bestandteil dieser Diagnostik. Er zeichnet sich durch eine hohe Genauigkeit in der Bestimmung des T- und N-Stadiums aus. Neue Behandlungskonzepte und die rasante Entwicklung konkurrierender Methoden erfordern eine neue Standortbestimmung.

Abstract

Modern therapy of the rectal carcinoma is dependent on sophisticated preinterventional diagnostics, which is decisive with regard to the indication for neoadjuvant therapy and influences the decision concerning the method of surgery. Endoscopic ultrasound is an established part of this diagnostic process. It is characterised by a high accuracy in T and N staging. New therapeutic concepts and the rapid development of competing methods make a new assessment of its value necessary.

Rektumkarzinom - kolorektales Karzinom - intraepitheliale Neoplasie - Endosonografie - Tumorstaging - neoadjuvante Therapie

rectal carcinoma - colorectal carcinoma - intraepithelial neoplasm - endoscopic ultrasound - tumour staging - neoadjuvant therapy

Literatur

• 1 Robert Koch Institut .http://www.rki.de. 
• 2 Wittekind C, Greene F L, Henson D E. UICC TNM Supplement. A commentary on uniform use. New York; John Wiley & Sons 2003 3 rd ed
• 3 Heald R J, Husband E M, Ryall R D. The mesorectum in rectal cancer surgery - the clue to pelvic recurrence?.  Br J Surg. 1982;  69 613-616
• 4 Stelzner F. Zur Anatomie des Mesenterium und des Mesorektums.  Viszeralchirurgie. 2003;  38 195-200
• 5 Hall N R, Finan P J, al JAberi T. et al . Circumferential margin involvement after mesorectal excision of rectal cancer with curative intent. Predictor of survival but not local recurrence?.  Dis Colon Rectum. 1998;  41 979-983
• 6 Lopez-Kostner F, Lavery I C, Hool G R. et al . Total mesorectal excision is not necessary for cancers of the upper rectum.  Surgery. 1998;  124 612-661
• 7 Heald R J, Ryall R D. Recurrence and survival after total mesorectal excision for rectal cancer.  Lancet. 1986;  1 (8496) 1479-1482
• 8 Kapiteijn E, Marijnen C A, Nagtegaal I D. et al . Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer.  N Engl J Med. 2001;  345 638-646
• 9 Schmiegel W, Pox C, Adler G. et al . S3-Leitlinienkonferenz „Kolorektales Karzinom”.  Z Gastroenterol. 2004;  42 129-177
• 10 Junginger T, Hermanek P, Oberholzer K. et al . Rektumkarzinom: Behandeln wir zu häufig neoadjuvant? Vorschläge zu einer selektiveren MRT-basierten Indikation.  Zentralbl Chir. 2006;  131 275-284
• 11 Habr-Gama A, Perez R O, Nadalin W. et al . Long-term results of preoperative chemoradiation for distal rectal cancer correlation between final stage and survival.  J Gastrointest Surg. 2005;  9 90-99
• 12 Wiersema M J, Harewood G C. Endoscopic ultrasound for rectal cancer.  Gastroenterol Clin North Am. 2002;  31 1093-1105
• 13 Harewood G C. Assessment of publication bias in the reporting of EUS performance in staging rectal cancer.  Am J Gastroenterol. 2005;  100 808-816
• 14 Bipat S, Glas A S, Slors F J. et al . Rectal Cancer: Local Staging and Assessment of Lymph node involvement with Endoluminal US, CT, and MR Imaging - A Meta-Analysis.  Radiology. 2004;  232 773-783
• 15 Marusch F, Koch A, Schmidt U. et al . Routine use of transrectal ultrasound in rectal carcinoma: results of a prospective multicenter study.  Endoscopy. 2002;  34 385-390
• 16 Garcia-Aguilar J, Pollack J, Lee S H. et al . Accuracy of endorectal ultrasonography in preoperative staging of rectal tumors.  Dis Colon Rectum. 2002;  45 10-15
• 17 Mackay S G, Pager C K, Joseph D. et al . Assessment of the accuracy of transrectal ultrasonography in anorectal neoplasia.  Br J Surg. 2003;  90 346-350
• 18 Orrom W J, Wong W D, Rothenberger D A. et al . Endorectal ultrasound in the preoperative staging of rectal tumors. A learning experience.  Dis Colon Rectum. 1990;  33 654-659
• 19 Carmody B J, Otchy D P. Learning curve of transrectal ultrasound.  Dis Colon Rectum. 2000;  43 193-197
• 20 Herzog U, Flue von M, Tondelli P. et al . How accurate is endorectal ultrasound in the preoperative staging of rectal cancer?.  Dis Colon Rectum. 1993;  36 127-134
• 21 Sailer M, Leppert R, Bussen D. et al . Influence of tumor position on accuracy of endorectal ultrasound staging.  Dis Colon Rectum. 1997;  40 1180-1186
• 22 Chapet O, Romestaing P, Mornex F. et al . Preoperative radiotherapy for rectal adenocarcinoma: Which are strong prognostic factors?.  Int J Radiat Oncol Biol Phys. 2005;  61 1371-1377
• 23 Starck M, Bohe M, Simanaitis M. et al . Rectal endosonography can distinguish benign rectal lesions from invasive early rectal cancers.  Colorectal Dis. 2003;  5 246-250
• 24 Borschitz T, Junginger T. Stellenwert der lokalen Exzision bei Rektumkarzinomen.  Viszeralchirurgie. 2006;  41 306-312
• 25 Kikuchi R, Takano M, Takagi K. et al . Management of early invasive colorectal cancer. Risk of recurrence and clinical guidelines.  Dis Colon Rectum. 1995;  38 1286-1295
• 26 Glancy D G, Pullyblank A M, Thomas M G. The role of colonoscopic endoanal ultrasound scanning (EUS) in selecting patients suitable for resection by transanal endoscopic microsurgery (TEM).  Colorectal Dis. 2005;  7 148-150
• 27 Hizawa K, Suekane H, Aoyagi K. et al . Use of endosonographic evaluation of colorectal tumor depth in determining the appropriateness of endoscopic mucosal resection.  Am J Gastroenterol. 1996;  91 768-771
• 28 Watanabe H, Miwa H, Terai T. et al . Endoscopic ultrasonography for colorectal cancer using submucosal saline solution injection.  Gastrointest Endosc. 1997;  45 508-511
• 29 McClave S A, Jones W F, Woolfolk G M. et al . Mistakes on EUS staging of colorectal carcinoma: error in interpretation or deception from innate pathologic features?.  Gastrointest Endosc. 2000;  51 682-689
• 30 Harewood G C, Kumar K S, Clain J E. et al . Clinical implications of quantification of mesorectal tumor invasion by endoscopic ultrasound: All T 3 rectal cancers are not equal.  J Gastroenterol Hepatol. 2004;  19 750-755
• 31 Willett C G, Badizadegan K, Ancukiewicz M. et al . Prognostic factors in stage T 3N0 rectal cancer: do all patients require postoperative pelvic irradiation and chemotherapy?.  Dis Colon Rectum. 1999;  42 167-173
• 32 Bianchi P P, Ceriani C, Rottoli M. et al . Endoscopic ultrasonography and magnetic resonance in preoperative staging of rectal cancer: comparison with histologic findings.  J Gastrointest Surg. 2005;  9 (9) 1222-1227
• 33 Kwok H, Bissett I P, Hill G L. Preoperative staging of rectal cancer.  Int J Colorectal Dis. 2000;  15 9-20
• 34 Beets-Tan R G, Beets G L. Rectal cancer: review with emphasis on MR imaging.  Radiology. 2004;  232 335-346
• 35 Gualdi G F, Casciani E, Guadalaxara A. et al . Local staging of rectal cancer with transrectal ultrasound and endorectal magnetic resonance imaging: comparison with histologic findings.  Dis Colon Rectum. 2000;  43 338-345
• 36 Meyenberger C, Huch Boni R A, Bertschinger P. et al . 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
• 37 Hunerbein M, Pegios W, Rau B. et al . Prospective comparison of endorectal ultrasound, three-dimensional endorectal ultrasound, and endorectal MRI in the preoperative evaluation of rectal tumors. Preliminary results.  Surg Endosc. 2000;  14 1005-1009
• 38 Nagtegaal I D, Marijnen C A, Kranenbarg E K. et al . 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. 2002;  26 350-357
• 39 Brown G, Radcliffe A G, Newcombe R G. et al . Preoperative assessment of prognostic factors in rectal cancer using high-resolution magnetic resonance imaging.  Br J Surg. 2003;  90 355-364
• 40 Bissett I P, Fernando C C, Hough D M. et al . Identification of the fascia propria by magnetic resonance imaging and its relevance to preoperative assessment of rectal cancer.  Dis Colon Rectum. 2001;  44 259-265
• 41 MERCURY Study group . Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study.  BMJ. 2006;  333 (7572) 779
• 42 Martling A, Holm T, Bremmer S. et al . Prognostic value of preoperative magnetic resonance imaging of the pelvis in rectal cancer.  Br J Surg. 2003;  90 1422-1428
• 43 Slater A, Halligan S, Taylor S A. et al . Distance between the rectal wall and mesorectal fascia measured by MRI: Effect of rectal distension and implications for preoperative prediction of a tumour-free circumferential resection margin.  Clin Radiol. 2006;  61 65-70
• 44 Beynon J, Mortensen N J, Foy D M. et al . Pre-operative assessment of local invasion in rectal cancer: digital examination, endoluminal sonography or computed tomography?.  Br J Surg. 1986;  73 1015-1017
• 45 Rifkin M D, Ehrlich S M, Marks G. Staging of rectal carcinoma: prospective comparison of endorectal US and CT.  Radiology. 1989;  170 319-322
• 46 Osti M F, Padovan F S, Pirolli C. et al . 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
• 47 Guinet C, Buy J N, Ghossain M A. et al . Comparison of magnetic resonance imaging and computed tomography in the preoperative staging of rectal cancer.  Arch Surg. 1990;  125 385-388
• 48 Kim N K, Kim M J, Yun S H. et al . 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
• 49 Kim C K, Kim S H, Choi D. et al . Comparison Between 3-T Magnetic Resonance Imaging and Multi-Detector Row Computed Tomography for the Preoperative Evaluation of Rectal Cancer.  J Comput Assist Tomogr. 2007;  31 853-859
• 50 Wolberink S V, Beets-Tan R G, Haas-Kock D F. et al . Conventional CT for the prediction of an involved circumferential resection margin in primary rectal cancer.  Dig Dis. 2007;  25 80-85
• 51 Kim J C, Kim H C, Yu C S. et al . Efficacy of 3-dimensional endorectal ultrasonography compared with conventional ultrasonography and computed tomography in preoperative rectal cancer staging.  Am J Surg. 2006;  192 89-97
• 52 Giovannini M, Bories E, Pesenti C. et al . Three-dimensional endorectal ultrasound using a new freehand software program: results in 35 patients with rectal cancer.  Endoscopy. 2006;  38 339-343
• 53 Hunerbein M, Totkas S, Ghadimi B M. et al . Preoperative evaluation of colorectal neoplasms by colonoscopic miniprobe ultrasonography.  Ann Surg. 2000;  232 46-50
• 54 Swanson R S, Compton C C, Stewart A K. et al . The prognosis of T 3N0 colon cancer is dependent on the number of lymph nodes examined.  Ann Surg Oncol. 2003;  10 65-71
• 55 Tepper J E, O’Connell M J, Niedzwiecki D. et al . Impact of number of nodes retrieved on outcome in patients with rectal cancer.  J Clin Oncol. 2001;  19 157-163
• 56 Bittner R, Burghardt J, Gross E. et al . Qualitätsindikatoren bei Diagnostik und Therapie des Rektumkarzinoms.  Zentralbl Chir. 2007;  132 85-94
• 57 Liersch T, Rothe H, Roedel C. et al . Chirurgie des Rektumkarzinoms - Qualitätssicherung.  Viszeralchirurgie. 2007;  42 66-72
• 58 Andreola S, Leo E, Belli F. et al . Manual dissection of adenocarcinoma of the lower third of the rectum specimens for detection of lymph node metastases smaller than 5 mm.  Cancer. 1996;  77 607-612
• 59 Dworak O. Number and size of lymph nodes and node metastases in rectal carcinomas.  Surg Endosc. 1989;  3 96-99
• 60 Spinelli P, Schiavo M, Meroni E. et al . Results of EUS in detecting perirectal lymph node metastases of rectal cancer: the pathologist makes the difference.  Gastrointest Endosc. 1999;  49 754-758
• 61 Beynon J, Mortensen N J, Foy D M. et al . Preoperative assessment of mesorectal lymph node involvement in rectal cancer.  Br J Surg. 1989;  76 276-279
• 62 Catalano M F, Sivak M V, Rice Jr T. et al . Endosonographic features predictive of lymph node metastasis.  Gastrointest Endosc. 1994;  40 442-446
• 63 Gleeson C F, Levy M J, Alberts F. Prospective Evaluation of Perirectal and Iliac Lymph Node EUS Criteria for Predicting Malignant Infiltration.  Gastrointest Endosc. 2007;  65 AB189
• 64 Nemoto Y, Kakemura T, Fujinama S. et al . Efficacy of 3-dimensional endorectal ultrasonography for diagnosis of lymph node metastasis with patients of rectal carcinoma compared with computed tomography.  Gastrointest Endosc. 2007;  65 AB189
• 65 Harewood G C, Wiersema M J, Nelson H. et al . A prospective, blinded assessment of the impact of preoperative staging on the management of rectal cancer.  Gastroenterology. 2002;  123 24-32
• 66 Shami V M, Parmar K S, Waxman I. Clinical impact of endoscopic ultrasound and endoscopic ultrasound-guided fine-needle aspiration in the management of rectal carcinoma.  Dis Colon Rectum. 2004;  47 59-65
• 67 Levy M J, Norton I D, Clain J E. et al . Prospective study of bacteremia and complications With EUS FNA of rectal and perirectal lesions.  Clin Gastroenterol Hepatol. 2007;  5 684-689
• 68 Levy M J, Alberts S R, Clain J E. et al . Endoscopic Ultrasound Guided Fine Needle Aspiration (EUS FNA) Detection of Malignant Iliac Lymph Nodes in Rectal Cancer.  Gastrointest Endosc. 2006;  63 AB97
• 69 Abdel-Nabi H, Doerr R J, Lamonica D M. et al . Staging of primary colorectal carcinomas with fluorine-18 fluorodeoxyglucose whole-body PET: correlation with histopathologic and CT findings.  Radiology. 1998;  206 755-760
• 70 Llamas-Elvira J M, Rodriguez-Fernandez A, Gutierrez-Sainz J. et al . Fluorine-18 fluorodeoxyglucose PET in the preoperative staging of colorectal cancer.  Eur J Nucl Med Mol Imaging. 2007;  34 859-867
• 71 Napoleon B, Pujol B, Berger F. et al . Accuracy of endosonography in the staging of rectal cancer treated by radiotherapy.  Br J Surg. 1991;  78 785-788
• 72 Rau B, Hunerbein M, Barth C. et al . Accuracy of endorectal ultrasound after preoperative radiochemotherapy in locally advanced rectal cancer.  Surg Endosc. 1999;  13 980-984
• 73 Vanagunas A, Lin D E, Stryker S J. Accuracy of endoscopic ultrasound for restaging rectal cancer following neoadjuvant chemoradiation therapy.  Am J Gastroenterol. 2004;  99 109-112
• 74 Maor Y, Nadler M, Barshack I. et al . Endoscopic ultrasound staging of rectal cancer: diagnostic value before and following chemoradiation.  J Gastroenterol Hepatol. 2006;  21 454-458
• 75 Gavioli M, Bagni A, Piccagli I. et al . Usefulness of endorectal ultrasound after preoperative radiotherapy in rectal cancer: comparison between sonographic and histopathologic changes.  Dis Colon Rectum. 2000;  43 1075-1083
• 76 Habr-Gama A, Souza P M, Ribeiro de U. et al . Low rectal cancer: impact of radiation and chemotherapy on surgical treatment.  Dis Colon Rectum. 1998;  41 1087-1096
• 77 Frank C D, Ross W A, Prindiville Jr T. et al . Accuracy of EUS with and without Preoperative Chemoradiation in Correlation with Pet Staging of Gastrointestinal Cancers.  Gastrointest Endosc. 2006;  63 AB265
• 78 Harewood G C. Assessment of clinical impact of endoscopic ultrasound on rectal cancer.  Am J Gastroenterol. 2004;  99 623-627
• 79 Beets-Tan R G, Lettinga T, Beets G L. Pre-operative imaging of rectal cancer and its impact on surgical performance and treatment outcome.  Eur J Surg Oncol. 2005;  31 681-688
• 80 Novell F, Pascual S, Viella P. et al . Endorectal ultrasonography in the follow-up of rectal cancer. Is it a better way to detect early local recurrence?.  Int J Colorectal Dis. 1997;  12 78-81
• 81 Lohnert M S, Doniec J M, Henne-Bruns D. Effectiveness of endoluminal sonography in the identification of occult local rectal cancer recurrences.  Dis Colon Rectum. 2000;  43 483-491
• 82 Mascagni D, Corbellini L, Urciuoli P. et al . Endoluminal ultrasound for early detection of local recurrence of rectal cancer.  Br J Surg. 1989;  76 1176-1180
• 83 Hunerbein M, Totkas S, Moesta K T. et al . The role of transrectal ultrasound-guided biopsy in the postoperative follow-up of patients with rectal cancer.  Surgery. 2001;  129 164-169
• 84 Stelzner F, Mallek von D. Das untere kloakogene Rektumviertel.  Viszeralchirurgie. 2005;  40 418-424
• 85 Merkel S, Meyer T, Gohl J. et al . Late locoregional recurrence in rectal carcinoma.  Eur J Surg Oncol. 2002;  28 716-722
• 86 Davila R E, Rajan E, Adler D. et al . The role of endoscopy in the diagnosis, staging, and management of colorectal cancer.  Gastrointest Endosc. 2005;  61 1-7