Conventional CT for the prediction of an involved circumferential resection margin in primary rectal cancer.
Dig Dis
; 25(1): 80-5, 2007.
Article
en En
| MEDLINE
| ID: mdl-17384512
ABSTRACT
PURPOSE:
To determine the accuracy of conventional computed tomography (CT) scan in the preoperative prediction of an involved circumferential resection margin (CRM) in primary rectal cancer.METHODS:
125 patients with biopsy-proven adenocarcinoma of the rectum underwent CT of the abdomen before undergoing total mesorectal excision. Scans were scored by three observers, differing in experience. The main outcome was yes/no involvement of the CRM. Histology was taken as reference standard.RESULTS:
For the most experienced observer, observer A, sensitivity was 46.7% and specificity 92.6%. For observer B, sensitivity was 46.7% and specificity 89.5%. For the least experienced observer C, sensitivity was 43.3% and specificity 92.6%. Inter-observer variability was good between observers A and B (kappa 0.648), B and C (kappa 0.648), and intermediate between A and C (kappa 0.542). Discrepancies occurred in a total of 34 patients; 25 had a CT scan of low technical quality, 10 an anteriorly located distal tumor.CONCLUSION:
Conventional CT scan lacks sensitivity for a clinical use in the preoperative assessment of an involved CRM in primary rectal cancer. Modern multislice spiral CT will probably resolve some of the problems of conventional CT; however, further research is needed to establish its role.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Neoplasias del Recto
/
Tomografía Computarizada por Rayos X
Tipo de estudio:
Diagnostic_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Dig Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2007
Tipo del documento:
Article
País de afiliación:
Países Bajos