Current Imaging Modalities Understage One-Third of Patients with Stage I Rectal Cancer: Implications for Treatment Selection.
Publication Title
The American surgeon
Document Type
Article
Publication Date
10-1-2018
Keywords
Adenocarcinoma; Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Multimodal Imaging; Neoplasm Staging; Patient Selection; Preoperative Care; Rectal Neoplasms; Retrospective Studies; United States; Young Adult
Abstract
Accurate preoperative clinical staging is essential to optimize the treatment of rectal cancer. Primary surgical resection is typically indicated for stage I disease, whereas neoadjuvant therapy is recommended for stages II and III. The objective of this study is to examine the accuracy of clinical staging using current imaging modalities in predicting pathologic stage and, thus, selecting appropriate treatment. Adult patients with nonmetastatic rectal cancer who underwent primary surgical resection were identified from the National Cancer Database between 2006 and 2014. Data on clinical and pathologic staging was obtained. Kappa index was used to determine the correlation between clinical and pathologic staging. A total of 13,175 patients were identified. The correlation between clinical and pathologic staging was 69 per cent for stage I (31% upstaged) (Kappa 0.54,
Clinical Institute
Cancer
Clinical Institute
Digestive Health
Specialty/Research Institute
Oncology
Specialty/Research Institute
Gastroenterology
Specialty/Research Institute
Diagnostic Imaging
