ULOGA ENDOREKTALNOG ULTRAZVUKA U ODREĐIVANJU STADIJUMA KARCINOMA REKTUMA.

Introduction Preoperative staging of rectal cancer is considered essential to select patients adequately for different therapeutic regimes. The aim of the present study was to evaluate the accuracy of enaorectal ultrasonography in preoperative staging ofrectal cancer. Materials and methods Fifty rectal cancer patients (31 men, 19 women) underwent endorectal ultrasonography with a 7.5-MHz probe. Thirty-eight of these patients had preoperative chemoradiation and in these patients examination was done before and after the radiotherapy treatment. The results of examinations were compared with the histological findings of the resected specimens. Results Histopathology showed 4 stage TO, 3 stage T4, 12 stage T2, 30 stage T3, and one stage T4 tumor. Nodal metastases were seen in 17 patients. The overall accuracy of endorectal ultrasonography for determining the depth of invasion (T stage) was 66% (33/50). The accuracy rate of T4 was 100% (Ill), T2 was 45% (9/20), T3 was 79% (22/28), and T4 was 100% (1/1). Overstaging was 18% (9150) and understaging 16% (8/50). In staging lymph node metastasis, the overall accuracy rate was 70% (J 8/25) with 18% (9/50) overstaged and 12% (6/50) understaged. With regard to nodal involvement, sensitivity was 65% and specificity 73%. Regarding penetration of the rectal wall (stages TJ and T2 vs stages T3 and T4 / Dukes' classification A versus B), endorectal sonography showed sensitivity, specificity. and accuracy of 74%. 68%, and 72%. respectively. Conclusion Endorectal ultrasonography is a valuable diagnostic modality for rectal cancer staging. It is fast, safe, accurate, well tolerated by the patient and cheap procedure and therefore should be used as a diagnostic modality of the first choice in rectal cancer staging although one must take into consideration possible limitations in cases of preoperative chemoradiation. [ABSTRACT FROM AUTHOR]

Preoperativno odredivanje stadijuma karcinoma rektuma je od presudnog značaja za planiranje terapije. individualno za svakog pacijenta Ova studija je imala za cilj da utvrdi tačnost endorektalnog ultrazvuka u preoperativnom određivanju stadijuma karcinoma rektuma. Pedeset boIesnika sa dijagnostikovanim karcinomom rektuma (3 I muškarac, 19 žena) pregIedani su endorektalnim ultrazvukom sa sondom od 7.5 MHz. Preoperativnu hemioiradijaciju primilo jc 38 pacijenata te je kod njih pregled rađen pre i nakon sprovedene zračne terapije. Rezultati pregleda su upoređivani sa histološkirn nalazima operativnog preparata. Patohistološki je postavljena dijagnoza 4 T0. 3 TI, 12 T2, 30 T3 i jedan T4 tumor. Metastaze u limfnim čvorovima su identifikovane kod 17 pacijenata. Ukupna tačnost endorektalnog ultrazvuka u određivanju T stadijuma bila je 66% a u određivanju N stadijuma 70%. U proceni da li postoji proboj zida rektuma iii ne (T I-2 vs. T3-4 / Dukes A vs. Dukes B) endorektalni ultrazvuk je pokazao sen zitivnost, specificnost i tacnost od 74%, 68% i 72%. Endorektalni ultrazvuk je pouzdana dijagnostička procedura u određivanju stadijuma karcinoma rektuma: To je brz, bezbedan, tacan i jeftin pregled, pacijenti ga dobro podnose, te treba da bude dijagnostička metoda izbora u odredivanju stadijuma karcinoma rektuma, iako treba uzeti u obzir izvesne teškoće u dijagnostici kod pacijenata koji su primili radioterapiju. [ABSTRACT FROM AUTHOR]