+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Imaging for predicting the risk factors--the circumferential resection margin and nodal disease--of local recurrence in rectal cancer: a meta-analysis

Imaging for predicting the risk factors--the circumferential resection margin and nodal disease--of local recurrence in rectal cancer: a meta-analysis

Seminars in Ultrasound, Ct, and Mr 26(4): 259-268

The aim of the present study was to conduct a meta-analysis of English literature on the accuracy of preoperative imaging in predicting the two most important risk factors for local recurrence in rectal cancer, the circumferential resection margin (CRM) and the nodal status (N-status). Articles published between 1985 and August 2004 that report on the diagnostic accuracy of endoluminal ultrasound (EUS), computed tomography (CT), or magnetic resonance imaging (MRI) in the evaluation of lymph node involvement were included. A similar search was done for the assessment of the circumferential resection margin in rectal cancer in the period from January 1985 till January 2005. The inclusion criteria were as follows: (1) more than 20 patients with histologically proven rectal cancer were included, (2) histology was used as the gold standard, and (3) results were given in a 2 x 2 contingency table or this table could otherwise be extracted from the article by two independent readers. Based on the results summary receiver operating characteristic (ROC) curves were constructed. Only 7 articles matching inclusion criteria were found concerning the CRM. The meta-analysis shows that MRI is rather accurate in diagnosing a close or involved CRM. For nodal status 84 articles could be included. The diagnostic odds ratio of EUS is estimated at 8.83. For MRI and CT, the diagnostic odds ratio are 6.53 and 5.86, respectively. The results show that EUS is slightly, but not significantly, better than MRI or CT for identification of nodal disease. There is no significant difference between the different modalities with respect to staging nodal status. At present, MRI is the only modality that predicts the circumferential resection margin with good accuracy, making it a good tool to identify high and low risk patients. Predicting the N-status remains a problem for the radiologist for every modality, although considering the new developments in MR imaging, this may change in the near future.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 049285862

Download citation: RISBibTeXText

PMID: 16152740

DOI: 10.1053/j.sult.2005.04.005

Related references

Circumferential resection margin involvement in stage III rectal cancer patients treated with curative resection followed by chemoradiotherapy: a surrogate marker for local recurrence?. Yonsei Medical Journal 54(1): 131-138, 2014

Impact of specific modes of circumferential resection margin involvement in rectal cancer local recurrence: A retrospective study. Journal of Surgical Oncology 118(7): 1122-1128, 2018

Risk Factors Associated With Circumferential Resection Margin Positivity in Rectal Cancer. Diseases of the Colon & Rectum 61(4): 433-440, 2018

Risk factors of circumferential resection margin involvement in the patients with extraperitoneal rectal cancer. Journal of the Korean Surgical Society 82(3): 165-171, 2012

Risk Factors Associated With Circumferential Resection Margin Positivity in Rectal Cancer: A Binational Registry Study. Diseases of the Colon and Rectum 61(4): 433-440, 2018

What is the best way to predict disease-free survival after preoperative radiochemotherapy for rectal cancer patients: tumor regression grading, nodal status, or circumferential resection margin invasion?. Journal of Clinical Oncology 24(8): 1319; Author Reply 1320-1, 2006

Diagnostic Accuracy of MRI for Assessment of T Category and Circumferential Resection Margin Involvement in Patients With Rectal Cancer: A Meta-Analysis. Diseases of the Colon and Rectum 59(8): 789-799, 2017

Is the circumferential resection margin a predictor of local recurrence after preoperative radiotherapy and optimal surgery for rectal carcinoma?. Colorectal Disease 9(8): 706-712, 2007

Role of total mesorectal excision and of circumferential resection margin in local recurrence and survival of patients with rectal carcinoma. Digestive Diseases 25(1): 51-55, 2007

Rectal washout and local recurrence in rectal resection for cancer: a meta-analysis. Colorectal Disease 14(11): 1313-1321, 2013

Association between irrigation fluids, washout volumes and risk of local recurrence of anterior resection for rectal cancer: a meta-analysis of 427 cases and 492 controls. Plos One 9(5): E95699, 2015

Role of circumferential margin involvement in the local recurrence of rectal cancer. Lancet (North American Edition) 344(8924): 707-711, 1994

Preoperative magnetic resonance imaging assessment of circumferential resection margin predicts disease-free survival and local recurrence: 5-year follow-up results of the MERCURY study. Journal of Clinical Oncology 32(1): 34-43, 2014

Analysis of risk factors for lymph nodal involvement in early stages of rectal cancer: when can local excision be considered an appropriate treatment? Systematic review and meta-analysis of the literature. International Journal of Surgical Oncology 2012: 438450, 2012

Rectal cancers with microscopic circumferential resection margin involvement (R1 resections): Survivals, patterns of recurrence, and prognostic factors. Journal of Surgical Oncology 114(5): 642-648, 2016