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A prospective study of the accuracy of preoperative computed tomographic staging of patients with biopsy-proven rectal carcinoma

  • Original Contributions
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Diseases of the Colon & Rectum

Abstract

From June 1983 to January 1986, 91 patients with biopsy-proven adenocarcinoma of the rectum had computed tomographic scans of the pelvis performed before treatment as part of a “sandwich” radiotherapy-surgery regimen. Two experienced diagnostic radiologists performed locoregional staging of all scans according to the University of California at San Francisco criteria; one of these radiologists repeated this staging at a later time to test the reproducibility of a single observer. Staging was performed without the use of any other radiographic studies or of any clinical information except the patients' age, sex, and the diagnosis of rectal carcinoma, to test the value of computed tomographic scans alone for staging. Agreement between the two stagings performed by the first observer was 51 percent, and interobserver agreement was only 37 percent. Agreement with Dukes' staging was only 33 percent. Therefore, preoperative pelvic computed tomographic scanning of primary rectal adenocarcinoma should not be relied upon for staging or for the selection of patients for treatment options.

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Authors and Affiliations

  1. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York

    Brenda Shank M.D., Ph.D.

  2. Department of Medical Imaging, Memorial Sloan-Kettering Cancer Center, New York, New York

    D. David Dershaw M.D. & James Caravelli M.D.

  3. Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York

    Jay Barth M.D. & Warren Enker M.D.

Authors
  1. Brenda Shank M.D., Ph.D.
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  2. D. David Dershaw M.D.
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  3. James Caravelli M.D.
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  4. Jay Barth M.D.
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  5. Warren Enker M.D.
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Shank, B., Dershaw, D.D., Caravelli, J. et al. A prospective study of the accuracy of preoperative computed tomographic staging of patients with biopsy-proven rectal carcinoma. Dis Colon Rectum 33, 285–290 (1990). https://doi.org/10.1007/BF02055469

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