Endoscopy Unit, National Cancer Institute and G Pascale Foundation Via Mariano Semola, 80131 Naples, Italy.
Clin Res Hepatol Gastroenterol. 2011 Oct;35(10):666-70. doi: 10.1016/j.clinre.2011.05.012. Epub 2011 Jul 22.
To date, the role of endoscopic ultrasound (EUS) in restaging locally advanced rectal cancer (LARC) after neoadjuvant chemoradiotherapy (NAT) have not been thoroughly investigated.
To evaluate accuracy and clinical usefulness of EUS for both staging and restaging LARC.
According to EUS staging, patients with LARC were enrolled in the study. Those who underwent surgery directly represented a control group useful for evaluating the accuracy of EUS in staging LARC. In the study group, EUS was repeated seven weeks after NAT, before surgery. The results of EUS were compared with the corresponding pTN stages.
From 2000 to 2006, 212 consecutive patients with RC underwent EUS staging. Among them EUS diagnosed 162 LARC (M/F = 93/69; mean age: 60 years [range 40-80]). The final study group included 85 patients with LARC. EUS restaging had an overall accuracy of 61% and 59% for T and N-stage, respectively. In the control group, the accuracy of EUS in staging LARC was 86% and 58% for T and N-stage, respectively.
EUS accurately stages LARC and enables appropriate decision-making, with selection of those patients who need NAT. On the other hand, EUS restaging of LARC after NAT has low accuracy and should not be used in clinical practice.
迄今为止，内镜超声（EUS）在新辅助放化疗（NAT）后局部晚期直肠癌（LARC）再分期中的作用尚未得到充分研究。
评估 EUS 对 LARC 分期和再分期的准确性和临床实用性。
根据 EUS 分期，将 LARC 患者纳入研究。直接接受手术的患者作为评估 EUS 分期 LARC 准确性的对照组。在研究组中，NAT 后 7 周，在手术前重复进行 EUS。将 EUS 结果与相应的 pTN 分期进行比较。
2000 年至 2006 年，连续 212 例 RC 患者接受了 EUS 分期。其中，EUS 诊断出 162 例 LARC（M/F=93/69；平均年龄：60 岁[范围 40-80]）。最终的研究组包括 85 例 LARC 患者。EUS 再分期的总体准确性分别为 T 分期 61%和 N 分期 59%。在对照组中，EUS 对 LARC 的分期准确性分别为 T 分期 86%和 N 分期 58%。
EUS 可准确分期 LARC，并能做出适当的决策，选择需要 NAT 的患者。另一方面，NAT 后 EUS 对 LARC 的再分期准确性较低，不应在临床实践中使用。
