Preoperative localization of distal colorectal tumours

The detection of true localization of the tumour are crucial to driving the proper treatment algorithm in distally-located colorectal cancers (CRCs). The performance of four methods; colonoscopy, computed tomography (CT), magnetic resonance imaging (MRI), and fluoro-deoxy-glucose-positron emission tomography scan (FDG/PET-CT), were evaluated to identify the localizations of distal colorectal malignancies according to the rectum, sigmoid colon and recto- sigmoid junction (RSJ).

Medical records of patients who underwent colorectal surgery for tumours located on the sigmoid colon, RSJ, or rectum were reviewed retrospectively.

In total, 156 patients were included in the study. In terms of overall accuracy, colonoscopy, CT, MRI and FDG/PET-CT had similar accuracy rates, with 74%, 67%, 75%, and 74%, respectively. Colonoscopy was relatively less sensitive for rectosigmoid tumours (33%), while CT was less sensitive for rectal tumours (26%). MRI was less specific for tumours located on the rectum (33%).

It is crucial to correctly identify the location of distal colorectal tumours in order to plan accurate treatment strategies. Preoperative modalities, including colonoscopy, CT, MRI, and FDG/PET-CT, do not provide excellent accuracy for tumours of the distal colorectal tumours. To increase the success of these modalities; combined use could be more successful.

Colonoscopy, Computed tomography Distal colorectal cancer, Magnetic resonance imaging.