PMID: 8951511Jan 1, 1996Paper

Preoperative lymph node staging in rectal cancer: a difficult challenge

International Journal of Colorectal Disease
R J DetryJ Rahier

Abstract

The specimens of 59 rectal cancers that had been scanned by preoperative endorectal ultrasound (EUS) were analysed by the pathologist in order to draw a map of the pararectal lymph nodes that should be detected by preoperative staging. 389 lymph nodes (LNs) were detected in the mesorectum, close to the tumour. Malignant LNs were larger than the non invaded: 17% of the LNs less than 6 mm in diameter were invaded whereas 23% of the LNs 6 mm or more in diameter were free of metastatic invasion. The non invaded LNs displayed three main patterns: follicle, sinusoidal and mixed types. Metastatic LNs were partially (n = 25) or totally (n = 76) invaded by tumoural cells. Diffuse involvement includes 4 different patterns: cellular proliferation, fibrosis, necrosis and cyst formation. Accuracy of EUS evaluated by a "patient by patient" comparison was 61%, with a sensitivity of 84% and a specificity of 39%. However, a comparison "lymph node by lymph node" showed a detection rate of 21% of the lymph nodes of 3 mm and more. It is concluded that a low percentage of LNs are detected by EUS in our experience. Metastatic and non metastatic LNs exhibit a great variety of morphological features and it seems difficult to reliably correlate metasta...Continue Reading

Citations

Sep 30, 2006·European Radiology·Christian KlessenMatthias Taupitz
Mar 24, 2007·Langenbeck's Archives of Surgery·Hiroyoshi MatsuokaAtsuhiko Sakamoto
Sep 24, 2004·European Journal of Radiology·Joo Hee KimRegina G H Beets-Tan
Apr 9, 2005·International Journal of Radiation Oncology, Biology, Physics·Olivier ChapetJean-Pierre Gerard
Mar 13, 2002·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·P Hohenberger
Jun 7, 2003·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·S T O'DwyerR Gardy
Aug 3, 1999·British Journal of Obstetrics and Gynaecology·H L HelinP Kirkinen
Jul 24, 2003·AJR. American Journal of Roentgenology·Michael H FuchsjägerGerhard L Lechner
May 20, 2004·AJR. American Journal of Roentgenology·Lennart Blomqvist, Gina Brown
Apr 30, 2002·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·W H SteupC J H van de Velde
Feb 21, 2003·The British Journal of Surgery·S G MackayM J Solomon
Jan 15, 2015·International Journal of Colorectal Disease·Im-Kyung KimKang Young Lee

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