CT of rectal cancer: Its accuracy and effect on patient management

Abstract

Twenty-four consecutive patients with rectal cancer were evaluated by pelvic computed tomography. The purpose of the study was threefold: First, we sought to assess the accuracy of preoperative CT staging. We were able preoperatively to judge correctly the extent of local disease in 22 of 24 patients. Second, we studied whether CT yielded significant new information, not obtainable by other diagnostic methods. In most patients this was the case. Finally, we assessed the extent to which this knowledge influenced patient management; i.e., decisions concerning how to treat the patient. CT findings influenced the treatment in fewer than one-half of the patients. Preoperative knowledge of the exact extent of the disease allows a rational decision as to what type of surgery, if any, is best suited to the patient. We concluded that the accuracy in staging, and the addition of new and unique information justified the routine use of CT prior to surgical intervention, in all patients with known invasive rectal cancer.