CT prediction of operative procedures for rectal cancer / 中华普通外科杂志

ABSTRACT

Objective To assess the value of 64-slice computer tomography used in the preoperative evaluation of rectal cancer to predict the operative procedures. Methods There were 51 pathologically proven rectal cancer patients recruited, undergoing multi-slice computer tomagraphy (MSCT) assessment preoperatively. Preoperative MSCT stage and predictive operative procedures were recorded to compare with postoperative pathological stage and practical operative procedures. Kappa Coefficient for Diagnosis Coherence and Spearman correlation analysis were performed. Results The overall accuracy of CT-TNM stages were 74.5% which led to high coherence to pathological TNM stage ( Kappa value = 0.658,P=0.000). The univariate analysis showed that distance from tumor to dentate line (F = 3.386, P =0.042 ) and tumor thickness (F = 4.542, P = 0.016) was a statistically risk factor for operative procedures. Moreover, the significant correlation between tumor thickness (cc =0.319, P =0.023 ), as well as CT-M stage (cc = 0.369, P = 0.008) and CT-TNM stage ( cc = 0.365, P = 0. 008), and operative procedures was observed, by means of conducting Spearman correlation. The possibility of developing palliative stoma was 75%, when sufficing both CT-MI stage and tumor thickness ≥20 mm; The possibility of performing sphincter sparing radical operation reached 86% when both CT-T stage < 4 and distance from tumor to dentate line were referred by MSCT. Conclusion The objective parameters influencing development of operative procedures, involving tumor thickness, CT-M stage and CT-T stage, can be rendered by MSCT preoperative assessment, which served as valuable reference for clinical decision of operative procedures in retal cancer.