Accuracy of intraoperative staging in colorectal cancer

In 216 patients with colorectal adenocarcinoma 'operative' and 'final' staging using Duke's classification were compared. The overall 'accuracy' of operative staging was 66% with 17% of tumours understaged and 17% overstaged. The major error was found in nodal staging. If selective peroperative adjuvant therapy is to be considered, efforts should be directed to improve operative nodal staging. Any recommendation for adjuvant perioperative chemotherapy based on operative staging alone will result in a significant number of patients having unnecessary treatment.