Efficacy of 3-Dimensional Endorectal Ultrasound for Staging Early Extraperitoneal Rectal Neoplasms

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art_PINTO_Efficacy_of_3Dimensional_Endorectal_Ultrasound_for_Staging_Early_2017.PDF (727.86 KB)
Citações na Scopus
9
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
NAHAS, Caio Sergio Rizkalah
Citação
DISEASES OF THE COLON & RECTUM, v.60, n.5, p.488-496, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
BACKGROUND: Adequate oncologic staging of rectal neoplasia is important for treatment and prognostic evaluation of the disease. Diagnostic methods such as endorectal ultrasound can assess rectal wall invasion and lymph node involvement. OBJECTIVE: The purpose of this study was to correlate findings of 3-dimensional endorectal ultrasound and pathologic diagnosis of extraperitoneal rectal tumors with regard to depth of rectal wall invasion, lymph node involvement, percentage of rectal circumference involvement, and tumor extension. DESIGN: Consecutive patients with extraperitoneal rectal tumors were prospectively assessed by 3-dimensional endorectal ultrasound blind to other staging methods and pathologic diagnosis. PATIENTS: Patients who underwent endorectal ultrasound followed by surgery were included in the study. SETTINGS: The study was conducted at a single academic institution. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive and negative predictive values, area under curve, and. coefficient between 3-dimensional endorectal ultrasound and pathologic diagnosis were determined. Intraclass correlation coefficient was calculated for tumor extension and percentage of rectal wall involvement. RESULTS: Forty-four patients (27 women; mean age = 63.5 years) were evaluated between September 2010 and June 2014. Most lesions were malignant (72.7%). For depth of submucosal invasion, 3-dimensional endorectal ultrasound showed sensitivity of 77.3%, specificity of 86.4%, positive predictive value of 85.0%, a negative predictive value of 79.2%, and an area under curve of 0.82. The weighted. coefficient for depth of rectal wall invasion staging was 0.67, and there was no agreement between 3-dimensional endorectal ultrasound and pathologic diagnosis for lymph node involvement (kappa = -0.164). Intraclass correlation coefficient for lesion extension and percentage of rectal circumference involvement were 0.45 and 0.66. A better correlation between 3-dimensional endorectal ultrasound and pathologic diagnosis was observed in tumors <5 cm and with <50% of rectal wall involvement. LIMITATIONS: The relatively small sample size of patients with early rectal lesions referred directly for surgery could represent a potential selection bias. CONCLUSIONS: Three-dimensional endorectal ultrasound was effective for determining rectal wall invasion and lesion extension in tumors <5 cm and with <50% of rectal wall invasion but was limited for detecting lymph node involvement in early rectal lesions.
Palavras-chave
Endorectal ultrasonography, Histopathology, Rectal neoplasms, Rectal tumor, Staging
URI
https://observatorio.fm.usp.br/handle/OPI/20050
Referências
  1. Akasu T, 2000, WORLD J SURG, V24, P1061
  2. ALTMAN DG, 1983, STATISTICIAN, V32, P307, DOI 10.2307/2987937
  3. Manger T, 2004, TECH COLOPROCTOL, V8, ps14
  4. Harewood GC, 2005, AM J GASTROENTEROL, V100, P808
  5. Harewood GC, 2002, GASTROENTEROLOGY, V123, P24
  6. Ashraf S, 2012, COLORECTAL DIS, V14, P821, DOI 10.1111/j.1463-1318.2011.02830.x
  7. Beets-Tan RGH, 2011, J MAGN RESON IMAGING, V33, P1012, DOI 10.1002/jmri.22475
  8. CATALANO MF, 1994, GASTROINTEST ENDOSC, V40, P442
  9. Edge SB, 2010, ANN SURG ONCOL, V17, P1471, DOI 10.1245/s10434-010-0985-4
  10. Fleiss JL, 1986, DESIGN ANAL CLIN EXP, P432
  11. Garcia-Aguilar J, 2002, DIS COLON RECTUM, V45, P10, DOI 10.1007/s10350-004-6106-3
  12. Habr-Gama A, 2004, ANN SURG, V240, P711, DOI 10.1097/01.sla.0000141194.27992.32
  13. HILDEBRANDT U, 1985, DIS COLON RECTUM, V28, P42, DOI 10.1007/BF02553906
  14. Hunerbein M, 2000, SURG ENDOSC-ULTRAS, V14, P1005, DOI 10.1007/s004640000345
  15. Karantanas AH, 2007, DIGEST DIS, V25, P20, DOI 10.1159/000099167
  16. Kim CK, 2006, EUR RADIOL, V16, P972, DOI 10.1007/s00330-005-0084-2
  17. Kim JC, 2006, AM J SURG, V192, P89, DOI 10.1016/j.amjsurg.2006.01.054
  18. Kim JC, 2002, SURG ENDOSC, V16, P1280, DOI 10.1007/s00464-001-8277-5
  19. Kirkwood BR, 2006, ESSENTIAL MED STAT, P502
  20. Kolev NY, 2014, INT SURG, V99, P106, DOI 10.9738/INTSURG-D-13-00227.1
  21. Krajewski KM, 2008, SEMIN ULTRASOUND CT, V29, P427, DOI 10.1053/j.sult.2008.10.005
  22. Kwok H, 2000, INT J COLORECTAL DIS, V15, P9, DOI 10.1007/s003840050002
  23. Marusch F, 2011, ENDOSCOPY, V43, P425, DOI 10.1055/s-0030-1256111
  24. Massari M, 1998, SURG LAPAROSC ENDOSC, V8, P438, DOI 10.1097/00019509-199812000-00008
  25. METERISSIAN S, 1994, ANN SURG ONCOL, V1, P111, DOI 10.1007/BF02303553
  26. Mondal D, 2014, INT J COLORECTAL DIS, V29, P1101, DOI 10.1007/s00384-014-1920-0
  27. Muthusamy VR, 2007, CLIN CANCER RES, V13, p6877S, DOI 10.1158/1078-0432.CCR-07-1137
  28. Puli SR, 2009, ANN SURG ONCOL, V16, P1255, DOI 10.1245/s10434-009-0337-4
  29. Puli S, 2009, ANN SURG ONCOL, V16, P254, DOI 10.1245/s10434-008-0231-5
  30. Quirke P, 2012, DIGEST DIS, V30, P2, DOI 10.1159/000341875
  31. RAFAELSEN SR, 1994, ACTA RADIOL, V35, P300
  32. Ren JH, 2012, CHINESE MED J-PEKING, V125, P3740, DOI 10.3760/cma.j.issn.0366-6999.2012.20.026
  33. Restivo A, 2015, DIGEST SURG, V32, P129, DOI 10.1159/000375537
  34. Santoro GA, 2007, COLORECTAL DIS, V9, P61, DOI 10.1111/j.1463-1318.2006.01012.x
  35. Santoro GA, 2009, DIS COLON RECTUM, V52, P1837, DOI 10.1007/DCR.0b013e3181b16ce9
  36. Saranovic D, 2007, EUR J RADIOL, V61, P480, DOI 10.1016/j.ejrad.2006.07.033
  37. SOLOMON MJ, 1993, DIS COLON RECTUM, V36, P200, DOI 10.1007/BF02051183
  38. Hulsmans FH, 1992, RADIOLOGY, V184, P553
  39. Vyslouzil K, 2007, HEPATO-GASTROENTEROL, V54, P1102
  40. Wolberink S V R C, 2006, Tech Coloproctol, V10, P171, DOI 10.1007/s10151-006-0275-0
  41. [张春爽 Zhang Chunshuang], 2013, [中国医学影像技术, Chinese Journal of Medical Imaging Technology], V29, P247
  42. Zhou YH, 2014, J CANCER RES THER, V10, pC319, DOI 10.4103/0973-1482.151542

Coleções
Artigos e Materiais de Revistas Científicas - FM/MGT
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - LIM/35
Artigos e Materiais de Revistas Científicas - LIM/37
Artigos e Materiais de Revistas Científicas - ODS/03