Endoscopic ultrasound for rectal cancer

The application of EUS has improved the way we evaluate and manage patients with rectal cancer. EUS has substantially greater sensitivity than CT in detecting advanced T stage tumors. Such improved sensitivity results in changes in preoperative therapy that would not otherwise have occurred without EUS. Although the addition of FNA provides little incremental effect on patient management, it carries the most potential for impacting management in those patients with early T stage disease, and its use should be considered in this subgroup of patients. Whether the accurate staging ability of EUS translates into improved outcomes in terms of reduced recurrence rates and ultimately prolonged survival remains uncertain. This will require further long-term outcome studies focusing on the endpoint of tumor recurrence and patient survival.