The role of intrarectal ultrasound (IRUS) in staging of rectal cancer and detection of extrarectal pathology

J. R. Harnsberger, P. Charvat, W. E. Longo, A. M. Vernava, Z. Salimi, T. Arends, G. Daniel, A. Senagore, J. Hoffman, E. Staren, D. Reed

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Intrarectal Ultrasound (IRUS) is rapidly becoming an effective tool in the staging of rectal cancer. Twenty-nine consecutive patients with adenocarcinoma of the rectum underwent both CT scanning and IRUS in the preoperative assessment of rectal cancer in an effort to correlate IRUS staging with surgical pathology, correlate tumor staging comparing IRUS with CT scan, and determine incidence of extrarectal pathology by IRUS. Patients were reviewed as to IRUS stage, results of CT scan, TNM stage of extirpated tumor, incidence of genitourinary pathology, and sonographic result of preoperative radiotherapy (RT). The mean age of all patients was 69 years; there were 25 males and four females. Twenty-four patients underwent proctectomy with either low pelvic anastomosis or end stoma; five underwent local surgical therapy. Thirteen patients received preoperative RT. CT scan correlated poorly with IRUS staging of tumors penetrating the muscularis propria. IRUS overstaged 40 per cent, understaged 5 per cent, and correctly staged 55 per cent of patients when compared with pathological specimens. Eleven of the 25 males (44 per cent) had abnormal prostates by IRUS. Five (20%) had further urologic intervention, resulting in two prostatic cancers found. Our data suggests that CT scan staging correlated poorly with IRUS staging. CT poorly determines depth of rectal tumor wall invasion. IRUS correlated well with pathology and understaged 5 per cent of patients before surgery. Genitourinary abnormalities were detected in a significant number of patients. IRUS is an effective modality for preoperative staging of rectal cancer. A significant number of genitourinary abnormalities may be anticipated when employing preoperative IRUS. Staging with IRUS allows for effective surgical decision-making and strategies for preoperative adjuvant therapy.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalThe American surgeon
Volume60
Issue number8
StatePublished - 1994
Externally publishedYes

Fingerprint

Rectal Neoplasms
Pathology
Urogenital Abnormalities
Neoplasm Staging
Radiotherapy
Surgical Pathology
Incidence
Rectum
Prostate
Prostatic Neoplasms
Decision Making
Adenocarcinoma
Therapeutics
Neoplasms

ASJC Scopus subject areas

  • Surgery

Cite this

Harnsberger, J. R., Charvat, P., Longo, W. E., Vernava, A. M., Salimi, Z., Arends, T., ... Reed, D. (1994). The role of intrarectal ultrasound (IRUS) in staging of rectal cancer and detection of extrarectal pathology. The American surgeon, 60(8), 571-577.

The role of intrarectal ultrasound (IRUS) in staging of rectal cancer and detection of extrarectal pathology. / Harnsberger, J. R.; Charvat, P.; Longo, W. E.; Vernava, A. M.; Salimi, Z.; Arends, T.; Daniel, G.; Senagore, A.; Hoffman, J.; Staren, E.; Reed, D.

In: The American surgeon, Vol. 60, No. 8, 1994, p. 571-577.

Research output: Contribution to journalArticle

Harnsberger, JR, Charvat, P, Longo, WE, Vernava, AM, Salimi, Z, Arends, T, Daniel, G, Senagore, A, Hoffman, J, Staren, E & Reed, D 1994, 'The role of intrarectal ultrasound (IRUS) in staging of rectal cancer and detection of extrarectal pathology', The American surgeon, vol. 60, no. 8, pp. 571-577.
Harnsberger JR, Charvat P, Longo WE, Vernava AM, Salimi Z, Arends T et al. The role of intrarectal ultrasound (IRUS) in staging of rectal cancer and detection of extrarectal pathology. The American surgeon. 1994;60(8):571-577.
Harnsberger, J. R. ; Charvat, P. ; Longo, W. E. ; Vernava, A. M. ; Salimi, Z. ; Arends, T. ; Daniel, G. ; Senagore, A. ; Hoffman, J. ; Staren, E. ; Reed, D. / The role of intrarectal ultrasound (IRUS) in staging of rectal cancer and detection of extrarectal pathology. In: The American surgeon. 1994 ; Vol. 60, No. 8. pp. 571-577.
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AU - Vernava, A. M.

AU - Salimi, Z.

AU - Arends, T.

AU - Daniel, G.

AU - Senagore, A.

AU - Hoffman, J.

AU - Staren, E.

AU - Reed, D.

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