Importance of endorectal 3-D-ultrasonography in diagnosis of rectum cancer

Abstract

Preoperative staging of rectal tumors is considered essential to tailor treatment for individual patients. The aim of the present study was to evaluate the accuracy of endorectal ultrasonography in preoperative staging of rectal cancer. 357 patients with rectal adenocarcinoma underwent endorectal ultrasonography evaluation during an eight year period. The evaluation was performed by four surgeons. We compared the endorectal ultrasonography staging with the pathology findings. Patients with preoperative chemoradiation were excluded from the study. Overall accuracy in assessing the level of rectal wall invasion was 77.3 %, with 9.3 % of the tumors overstaged and 8.1 % understaged. Accuracy in assessing nodal involvement in 313 patients treated with radical surgery was 74.9 %, with 8.9 % overstaged and 8.9 % understaged. The accuracy of endorectal ultrasonography in assessing the deepth of tumor invasion is good, but lower than previosly reported. The technique is precise in distinguishing between benign tumors and invasive cancer. The results depend on the experience of the surgeon.