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Prediction of Lateral Pelvic Lymph-Node Metastasis in Low Rectal Cancer by Magnetic Resonance Imaging

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Abstract

Objective

This study was designed to evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) for lateral pelvic lymph-node metastasis.

Patients

Eighty-four patients with primary lower rectal cancer were examined by MRI and subsequently underwent radical surgery with lateral pelvic lymph-node dissection, without preoperative treatment. Lateral lymph-node metastases were assessed preoperatively by MRI, and the results were compared with the histopathological findings. The criterion for lateral lymph-node metastasis was any recognizable lymph node in the pelvic wall, regardless of diameter.

Result

Lateral pelvic lymph-node metastasis was diagnosed on preoperative MRI in 16 patients (19.9 %). The overall patient-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI were 75, 69.1, 36.4, 92.2, and 70.2 %, respectively. When a cut-off value of 10 mm was used for diagnosis, the corresponding values were 43.8, 98.5, 87.5, 88.1, and 88.1 %, respectively. The mean diameter of metastatic nodes (14.7 mm) was significantly larger than that of negative nodes (5.7 mm; P < 0.01).

Conclusion

MRI is an effective technique for predicting lateral pelvic node involvement and thus may facilitate preoperative decision-making in rectal cancer treatment. A cut-off value of 10 mm is useful for avoiding unnecessary lateral lymph-node dissection.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Yokohama City University Graduate School Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Atsushi Ishibe, Jun Watanabe, Yusuke Suwa, Shinsuke Suzuki, Kazuteru Watanabe, Yasushi Ichikawa & Itaru Endo

  2. Department of Surgery, Gastroenterological Center, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Mitsuyoshi Ota, Amane Kanazawa & Chikara Kunisaki

Authors
  1. Atsushi Ishibe
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  2. Mitsuyoshi Ota
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  3. Jun Watanabe
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  4. Yusuke Suwa
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  5. Shinsuke Suzuki
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  6. Amane Kanazawa
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  7. Kazuteru Watanabe
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  8. Yasushi Ichikawa
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  9. Chikara Kunisaki
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  10. Itaru Endo
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Correspondence to Atsushi Ishibe.

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Ishibe, A., Ota, M., Watanabe, J. et al. Prediction of Lateral Pelvic Lymph-Node Metastasis in Low Rectal Cancer by Magnetic Resonance Imaging. World J Surg 40, 995–1001 (2016). https://doi.org/10.1007/s00268-015-3299-7

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  • DOI: https://doi.org/10.1007/s00268-015-3299-7

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