Impact of video colonoscopy on stage and outcome of patients with symptomatic colorectal cancer
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Double-contrast barium enema still is regarded by many as the investigation of choice for patients with large bowel symptoms. The aim of this study was to compare the stage and outcome of patients with colorectal cancer diagnosed by video colonoscopy (VC) and barium enema (BE) in a single institution.
Between July 1997 and December 2001, data were gathered prospectively in a series of 489 patients presenting consecutively with symptomatic colorectal cancer. Selection of patients for either VC or BE investigation was made by the clinician who examined the patient in the clinic. Of the 489 patients, 82 were excluded because they presented acutely or other methods were used for the diagnosis.
A diagnosis of colorectal cancer was determined by VC for 292 patients and by BE for 115 patients. The patients in both groups were similar in terms of age, gender, and site of disease. Stage 1 disease (T1/2NO) was diagnosed for 87 (29.8%) patients in the VC group, as compared with 10 (8.7%) in the BE group (p < 0.0001). Early colorectal cancer (T1) was diagnosed for 43 patients in the VC group as compared to 1 patient in the BE group (p < 0.0001). During a median follow-up period of 33 months, 8.2% of the patients in the VC group had experienced recurrence after curative resection, as compared with 17.4% of the patients in the BE group p = 0.018). Freedom from disease (p = 0.02) and overall survival (p = 0.03) were significantly increased in the VC group.
Videocolonoscopy used as the investigation of choice for patients with large bowel symptoms detects colorectal cancer at an earlier stage and has a significant impact on the outcome for this condition.
- Fenlon, HM, Nunes, DP, Schroy, PC, Barish, MA, Clarke, PD, Ferrucci, JT (1999) A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 341: pp. 1496-1503 CrossRef
- MacKenzie, S, O’Dwyer, PJ (2000) Surveillance after colorectal cancer resection. Lancet 355: pp. 1095 CrossRef
- Moreaux, J, Catala, M (1987) Carcinoma of the colon: long-term survival and prognosis after surgical treatment in a series of 798 patients. World J Surg 11: pp. 804-809
- Quirke, P, Durdey, P, Dixon, MF, Williams, NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection: histopathological study of lateral tumour spread and surgical excision. Lancet ii: pp. 996-999 CrossRef
- Rembacken, BJ, Fujii, T, Cairns, A, Dixon, MF, Yoshida, S, Chalmers, DM, Axon, AT (2000) Flat and depressed colonic neoplasms: a prospective study of 1,000 colonoscopies in the UK. Lancet 355: pp. 1211-1214 CrossRef
- Rex, DK, Rahmani, EY, Haseman, JH, Lemmel, GT, Kaster, S, Buckley, JS (1997) Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology 112: pp. 17-23
- Rex, DK, Weddle, RA, Lehman, GA, Pound, DC, O’Connor, KW, Hawes, RH, Dittus, RS, Lappas, JC, Lumeng, L (1990) Flexible sigmoidoscopy plus air contrast barium enema versus colonoscopy for suspected lower gastrointestinal bleeding. Gastroenterology 98: pp. 855-861
- Smith, GA, Oien, KA, O’Dwyer, PJ (1999) Frequency of early colorectal cancer in patients undergoing colonoscopy. Br J Surg 86: pp. 1288-1231
- Smith, GA, O’Dwyer, PJ (2001) Sensitivity of double-contrast barium enema and colonoscopy for the detection of colorectal neoplasms. Surg Endosc 15: pp. 649-652 CrossRef
- Single flexible sigmoidoscopy screening to prevent colorectal cancer: baseline findings of a UK multicentre randomised trial. Lancet 359: pp. 1291-1300
- Winawer, SJ, Zauber, AG, Ho, MN, O’Brien, MJ, Gottlieb, LS, Stemberg, SS, Waye, JD, Schapiro, M, Bond, JH, Panish, JF (1993) Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med 329: pp. 1977-1981 CrossRef
- Winawer, SJ, Stewart, ET, Zauber, AG, Bond, JH, Ansel, H, Waye, JD, Hall, D, Hamlin, JA, Schapiro, M, O’Brien, MJ, Stemberg, SS, Gottlieb, LS (2000) A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy. N Engl J Med 342: pp. 1766-1772 CrossRef
- Impact of video colonoscopy on stage and outcome of patients with symptomatic colorectal cancer
Surgical Endoscopy And Other Interventional Techniques
Volume 18, Issue 8 , pp 1268-1271
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Colorectal cancer
- Industry Sectors