Rectal Cancer: Preoperative Staging Using Endorectal Ultrasonography (Methodology)
The prognosis of patients with rectal cancer is closely related to accurately assessing the extent of tumor within or beyond the rectal wall, and to the presence or absence of lymph node involvement. The risk of postoperative tumor recurrence is 5% for T1, 10% for T2, and 25% for T3. In case of lymph node involvement, the risk of tumor recurrence increases to 33% for T2 tumor and 66% for T3 tumor. The purpose of preoperative staging of rectal cancer is to predict as accurately as possible the two most important factors for determining the prognosis and risk of recurrence: rectal wall infiltration and regional lymph node metastasis. Accurate preoperative staging of rectal cancer facilitates optimal management, and it helps to determine the need for preoperative neoadjuvant therapy. Those patients whose tumors are confined within the mucosa/submucosa (T1) can be offered local excision as a good alternative to a radical operation. For more advanced rectal lesions, neoadjuvant chemoradiation succeeds in increasing the number of sphincter-preserving operations and improves the local tumor control and survival of these patients.
KeywordsRectal Cancer Rectal Wall Muscularis Propria Preoperative Staging Endorectal Ultrasonography
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