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The value of endosonographic rectal carcinoma staging in routine diagnostics: a 10-year analysis

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Abstract

Background

Endosonography is currently the gold standard for the local staging of rectal carcinoma, but its accuracy varies from 62% to 91%. This study aimed to determine the accuracy of endosonography, to evaluate the interobserver variability, and to compare the performance of the 7.5-MHz and the 10-MHz ultrasound scanners.

Methods

Between 1990 and 2000, 458 patients with rectal cancer were included in the study. All the patients had undergone rectal endosonography with a 7.5-MHz scan (period 1: 1990–1996) or a 10-MHz scan (period 2: 1997–2000). Endosonographic staging was compared with pathologic staging.

Results

The overall rate for correctly classified patients was 69% with respect to the T category and 68% with respect to the N category. There was no difference between the two scanners. In terms of accuracy, the T3 category tumors were the most (86%) and the T4 tumors the least (36%) accurately classified. Overstaging of tumors (19%) was much more frequent than understaging (12%). A high interobserver variability of 61% to 77% was noted. For pT1 tumors, the 10-MHz scan was almost two times more accurate than the 7.5-MHz scan (71% vs 36%).

Conclusions

The accuracy of endosonographic staging of rectal carcinoma very much depends on the T category. A high-resolution scanner and an experienced examiner can help to ensure that endosonography remains an important tool in the staging process of patients with rectal carcinoma, especially early carcinoma.

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Authors and Affiliations

  1. Department Surgery, Chirurgische Klinik und Poliklinik, Klinikum rechts der lsar, Technische Universität München, Ismaningerstrasse 22, 81675, München, Germany

    W. K. H. Kauer, L. Prantl, H. J. Dittler & J. R. Siewert

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  1. W. K. H. Kauer
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  2. L. Prantl
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  3. H. J. Dittler
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  4. J. R. Siewert
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Correspondence to W. K. H. Kauer.

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Kauer, W.K.H., Prantl, L., Dittler, H.J. et al. The value of endosonographic rectal carcinoma staging in routine diagnostics: a 10-year analysis. Surg Endosc 18, 1075–1078 (2004). https://doi.org/10.1007/s00464-003-9088-7

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  • DOI: https://doi.org/10.1007/s00464-003-9088-7

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