Role of endoscopic ultrasonography in the loco-regional staging of patients with rectal cancer  被引量:13

Role of endoscopic ultrasonography in the loco-regional staging of patients with rectal cancer

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作  者:Pietro Marone Mario de Bellis Valentina D'Angelo Paolo Delrio Valentina Passananti Elena Di Girolamo Giovanni Battista Rossi Daniela Rega Maura Claire Tracey Alfonso Mario Tempesta 

机构地区:[1]Endoscopy Unit, Istituto Nazionale Tumori-IRCCS [2]Division of Colorectal Surgical Oncology, Istituto Nazionale Tumori-IRCCS [3]Division of Gastroenterology Medical School, University Federico II [4]Division of Thoracic Surgery Istituto Nazionale Tumori-IRCCS

出  处:《World Journal of Gastrointestinal Endoscopy》2015年第7期688-701,共14页世界胃肠内镜杂志(英文版)(电子版)

摘  要:The prognosis of rectal cancer(RC) is strictly related to both T and N stage of the disease at the time of diagnosis. RC staging is crucial for choosing the best multimodal therapy: patients with high risk locally advanced RC(LARC) undergo surgery after neoadjuvant chemotherapy and radiotherapy(NAT); those with low risk LARC are operated on after a preoperative short-course radiation therapy; finally, surgery alone is recommended only for early RC. Several imaging methods are used for staging patients with RC: computerized tomography, magnetic resonance imaging, positron emission tomography, and endoscopic ultrasound(EUS). EUS is highly accurate for the loco-regional staging of RC, since it is capable to evaluate precisely the mural infiltration of the tumor(T), especially in early RC. On the other hand, EUS is less accurate in restaging RC after NAT and before surgery. Finally, EUS is indicated for follow-up of patients operated on for RC, where there is a need for the surveillance of the anastomosis. The aim of this review is to highlight the impact of EUS on the management of patients with RC, evaluating its role in both preoperative staging and follow-up of patients after surgery.The prognosis of rectal cancer (RC) is strictly relatedto both T and N stage of the disease at the time ofdiagnosis. RC staging is crucial for choosing the bestmultimodal therapy: patients with high risk locallyadvanced RC (LARC) undergo surgery after neoadjuvantchemotherapy and radiotherapy (NAT); those withlow risk LARC are operated on after a preoperativeshort-course radiation therapy; finally, surgery aloneis recommended only for early RC. Several imagingmethods are used for staging patients with RC: computerizedtomography, magnetic resonance imaging,positron emission tomography, and endoscopic ultrasound(EUS). EUS is highly accurate for the loco-regionalstaging of RC, since it is capable to evaluate preciselythe mural infiltration of the tumor (T), especially in earlyRC. On the other hand, EUS is less accurate in restagingRC after NAT and before surgery. Finally, EUS is indicatedfor follow-up of patients operated on for RC, where thereis a need for the surveillance of the anastomosis. Theaim of this review is to highlight the impact of EUS onthe management of patients with RC, evaluating its rolein both preoperative staging and follow-up of patientsafter surgery.

关 键 词:Rectal cancer STAGING Endoscopic ultrasonography ACCURACY Therapeutic strategy 

分 类 号:R735.37[医药卫生—肿瘤]

 

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