Endosonographic evaluation of low rectal cancer

Introduction: Endoluminal ultrasonography has an ever growing importance in the staging of malignant colon tumours. Identifying the degree of local tumor spread plays a key role in the decision making when tayloring surgical radicality. Also this diagnostic tool influences additional adjuvant therapy. Our goal was to show the degree of diagnostic accuracy of this method identifying the presence and local spread of the primary or recidive tumour in our consecutive series of examinations.

Materials and methods: Thirty-two patients with histologically proven low rectal cancer underwent endoluminal transrectal sonography between February 2003 and January 2004. On 29 patients primary staging procedure was performed, in three cases recurrent disease was investigated. Sonorgaphies were performed by on a Hitachi EUB-450 ultrasound equipment with a 7.5MHz linear transrectal probe. Results were compared to histological diagnosis.

Results: Three patients with primary cancer were not operated, therefore they were excluded from the study as well as the 3 cases with recidive disease due to the small number of patients from wich no significant conclusion can be drawn. From the reminding 26 cases with primary cancer our results were in accordance with histological results in 24 cases. In 2 cases there sonography overstaged the spread of disease.

Our study showed transrectal sonography has 92% accuracy in the local staging of the primary low rectal tumours. Transrectal sonography overestimated tumour spread in 2 cases.

Conclusion: Transrectal ultrasonography plays an important role in surgical decision making in rectal cancer, performing this diagnostic approach should be mandatory in the diagnostic workup.