[Rectal cancer staging with endoscopic ultrasonography: correlation with pathological staging]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Diagnostic Imaging

Background:

• Accurate staging of rectal cancer is crucial for effective treatment planning.
• Endoscopic ultrasound (EUS) is a key imaging modality for local staging.

Purpose of the Study:

• To evaluate the diagnostic accuracy of EUS for staging rectal cancer in a clinical setting.
• To compare EUS staging (uTN) with histopathological staging (pTN) as the gold standard.

Main Methods:

• Prospective study of 120 rectal cancer patients from 2002-2006.
• 36 patients with complete EUS and surgical treatment without neoadjuvant therapy were analyzed.
• Sensitivity, specificity, PPV, NPV, accuracy, and kappa statistics were calculated for T and N staging.

Main Results:

• Overall T stage accuracy was 83% and N stage accuracy was 72%.
• High accuracy was observed for T1 (97%), T2 (86%), and T3 (89%) stages.
• Quadratic weighted kappa for T stage was 0.87 (very good agreement), while kappa for N stage was 0.005 (poor agreement).

Conclusions:

• EUS provides reliable T and N staging for rectal cancer, with diagnostic accuracy comparable to published data.
• EUS demonstrates very good agreement with histopathology for T staging of rectal cancer.