Preoperative Evaluation of Pelvic Lateral Lymph Node of Patients with Lower Rectal Cancer: Comparison Study of MR Imaging and CT in 53 Patients

Overview

Journal Langenbecks Arch Surg

Specialty General Surgery

Date 2006 Jul 19

PMID 16847648

Citations 21

Authors

Kazuo Arii

Katsunari Takifuji

Shozo Yokoyama

Kenji Matsuda

Takashi Higashiguchi

Toshiji Tominaga

Yoshimasa Oku

Masaji Tani

Hiroki Yamaue

Affiliations

Soon will be listed here.

Abstract

Background: Preoperative assessment of the lateral pelvic lymph nodes is important for treatment strategy to patients with lower rectal cancer.

Materials And Methods: Fifty-three patients with primary lower rectal cancer were preoperatively assessed by spiral computed tomography (CT) and magnetic resonance imaging (MRI) at 1.5 T with a phased-array coil. Preoperative tumor and lymph node stages were compared with the final histological findings.

Results: The MRI tumor stage coincided with the histological stage in 36 of 53 patients (68%). The MRI and CT lymph node stage coincided with the histological stage in 33 (62%) and 26 (49%) of 53 patients, respectively. However the accuracy of MRI in detecting the lateral pelvic lymph node involvement was 83%, compared to 77% of CT (p<0.05).

Conclusions: With the use of MRI, the lateral pelvic lymph node involvement can be predicted with high accuracy, allowing preoperative identification of patients who need radiotherapy or extensive surgery to escape recurrence.

Citing Articles

Clinical Relevance of Lateral Pelvic Lymph Node Dissection for Enlarged Lateral Nodes in Locally Advanced Low Rectal Cancer without Preoperative Treatment.

Ouchi A, Komori K, Kinoshita T, Sato Y, Ito S, Abe T J Anus Rectum Colon. 2023; 7(2):126-134.

PMID: 37113578 PMC: 10129353. DOI: 10.23922/jarc.2022-064.

Preoperative and postoperative prognostic factors of patients with stage II/III lower rectal cancer without neoadjuvant therapy in the clinical trial (JCOG0212).

Ohue M, Fujita S, Mizusawa J, Kanemitsu Y, Hamaguchi T, Tsukamoto S Jpn J Clin Oncol. 2021; 52(2):114-121.

PMID: 34865105 PMC: 9055856. DOI: 10.1093/jjco/hyab183.

Lateral pelvic lymph nodes for rectal cancer: A review of diagnosis and management.

Ogawa S, Itabashi M, Inoue Y, Ohki T, Bamba Y, Koshino K World J Gastrointest Oncol. 2021; 13(10):1412-1424.

PMID: 34721774 PMC: 8529924. DOI: 10.4251/wjgo.v13.i10.1412.

Efficacy of positron emission tomography in diagnosis of lateral lymph node metastases in patients with rectal Cancer: a retrospective study.

Yukimoto R, Uemura M, Tsuboyama T, Hata T, Fujino S, Ogino T BMC Cancer. 2021; 21(1):520.

PMID: 33962569 PMC: 8105987. DOI: 10.1186/s12885-021-08278-6.

Deep learning-based fully automated detection and segmentation of lymph nodes on multiparametric-mri for rectal cancer: A multicentre study.

Zhao X, Xie P, Wang M, Li W, Pickhardt P, Xia W EBioMedicine. 2020; 56:102780.

PMID: 32512507 PMC: 7276514. DOI: 10.1016/j.ebiom.2020.102780.

References

Guinet C, Buy J, Ghossain M, Sezeur A, Mallet A, Bigot J . Comparison of magnetic resonance imaging and computed tomography in the preoperative staging of rectal cancer. Arch Surg. 1990; 125(3):385-8. DOI: 10.1001/archsurg.1990.01410150107019. View

Baeten C, Jager J, Langendijk J, Schouten L, Volovics A, Arends J . Prognostic significance of radial margins of clearance in rectal cancer. Br J Surg. 1996; 83(6):781-5. DOI: 10.1002/bjs.1800830617. View

Macfarlane J, Ryall R, Heald R . Mesorectal excision for rectal cancer. Lancet. 1993; 341(8843):457-60. DOI: 10.1016/0140-6736(93)90207-w. View

Phillips R, Hittinger R, Blesovsky L, Fry J, Fielding L . Local recurrence following 'curative' surgery for large bowel cancer: I. The overall picture. Br J Surg. 1984; 71(1):12-6. DOI: 10.1002/bjs.1800710104. View

Cedermark B, Dahlberg M, Glimelius B, Pahlman L, Rutqvist L, Wilking N . Improved survival with preoperative radiotherapy in resectable rectal cancer. N Engl J Med. 1997; 336(14):980-7. DOI: 10.1056/NEJM199704033361402. View

Butch R, Stark D, Wittenberg J, Tepper J, Saini S, Simeone J . Staging rectal cancer by MR and CT. AJR Am J Roentgenol. 1986; 146(6):1155-60. DOI: 10.2214/ajr.146.6.1155. View

Hodgman C, MacCarty R, Wolff B, May G, Berquist T, Sheedy 2nd P . Preoperative staging of rectal carcinoma by computed tomography and 0.15T magnetic resonance imaging. Preliminary report. Dis Colon Rectum. 1986; 29(7):446-50. DOI: 10.1007/BF02561581. View

Kim N, Kim M, Yun S, Sohn S, Min J . Comparative study of transrectal ultrasonography, pelvic computerized tomography, and magnetic resonance imaging in preoperative staging of rectal cancer. Dis Colon Rectum. 1999; 42(6):770-5. DOI: 10.1007/BF02236933. View

SCHNALL M, Furth E, Rosato E, Kressel H . Rectal tumor stage: correlation of endorectal MR imaging and pathologic findings. Radiology. 1994; 190(3):709-14. DOI: 10.1148/radiology.190.3.8115616. View

10.

Sagar P, Pemberton J . Surgical management of locally recurrent rectal cancer. Br J Surg. 1996; 83(3):293-304. DOI: 10.1002/bjs.1800830305. View

11.

Cawthorn S, Parums D, Gibbs N, AHern R, Caffarey S, Broughton C . Extent of mesorectal spread and involvement of lateral resection margin as prognostic factors after surgery for rectal cancer. Lancet. 1990; 335(8697):1055-9. DOI: 10.1016/0140-6736(90)92631-q. View

12.

Thompson W, Halvorsen R, Foster Jr W, Roberts L, Gibbons R . Preoperative and postoperative CT staging of rectosigmoid carcinoma. AJR Am J Roentgenol. 1986; 146(4):703-10. DOI: 10.2214/ajr.146.4.703. View

13.

Hadfield M, Nicholson A, Macdonald A, Farouk R, Lee P, Duthie G . Preoperative staging of rectal carcinoma by magnetic resonance imaging with a pelvic phased-array coil. Br J Surg. 1997; 84(4):529-31. View

14.

Heriot A, Grundy A, Kumar D . Preoperative staging of rectal carcinoma. Br J Surg. 1999; 86(1):17-28. DOI: 10.1046/j.1365-2168.1999.00996.x. View

15.

de Lange E, FECHNER R, Edge S, Spaulding C . Preoperative staging of rectal carcinoma with MR imaging: surgical and histopathologic correlation. Radiology. 1990; 176(3):623-8. DOI: 10.1148/radiology.176.3.2389016. View

16.

Mori T, Takahashi K, Yasuno M . Radical resection with autonomic nerve preservation and lymph node dissection techniques in lower rectal cancer surgery and its results: the impact of lateral lymph node dissection. Langenbecks Arch Surg. 1999; 383(6):409-15. DOI: 10.1007/s004230050153. View

17.

Wiggers T . Staging of rectal cancer. Br J Surg. 2003; 90(8):895-6. DOI: 10.1002/bjs.4279. View

18.

Heald R, Ryall R . Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986; 1(8496):1479-82. DOI: 10.1016/s0140-6736(86)91510-2. View

19.

Hulsmans F, Tio T, Fockens P, Bosma A, Tytgat G . Assessment of tumor infiltration depth in rectal cancer with transrectal sonography: caution is necessary. Radiology. 1994; 190(3):715-20. DOI: 10.1148/radiology.190.3.8115617. View

20.

THALER W, Watzka S, Martin F, La Guardia G, Psenner K, Bonatti G . Preoperative staging of rectal cancer by endoluminal ultrasound vs. magnetic resonance imaging. Preliminary results of a prospective, comparative study. Dis Colon Rectum. 1994; 37(12):1189-93. DOI: 10.1007/BF02257780. View