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PMID- 28383448
DA  - 20170406
DCOM- 20170418
LR  - 20170418
IS  - 1530-0358 (Electronic)
IS  - 0012-3706 (Linking)
VI  - 60
IP  - 5
DP  - 2017 May
TI  - Efficacy of 3-Dimensional Endorectal Ultrasound for Staging Early Extraperitoneal
      Rectal Neoplasms.
PG  - 488-496
LID - 10.1097/DCR.0000000000000781 [doi]
AB  - BACKGROUND: Adequate oncologic staging of rectal neoplasia is important for
      treatment and prognostic evaluation of the disease. Diagnostic methods such as
      endorectal ultrasound can assess rectal wall invasion and lymph node involvement.
      OBJECTIVE: The purpose of this study was to correlate findings of 3-dimensional
      endorectal ultrasound and pathologic diagnosis of extraperitoneal rectal tumors
      with regard to depth of rectal wall invasion, lymph node involvement, percentage 
      of rectal circumference involvement, and tumor extension. DESIGN: Consecutive
      patients with extraperitoneal rectal tumors were prospectively assessed by
      3-dimensional endorectal ultrasound blind to other staging methods and pathologic
      diagnosis. PATIENTS: Patients who underwent endorectal ultrasound followed by
      surgery were included in the study. SETTINGS: The study was conducted at a single
      academic institution. MAIN OUTCOME MEASURES: Sensitivity, specificity, positive
      and negative predictive values, area under curve, and kappa coefficient between
      3-dimensional endorectal ultrasound and pathologic diagnosis were determined.
      Intraclass correlation coefficient was calculated for tumor extension and
      percentage of rectal wall involvement. RESULTS: Forty-four patients (27 women;
      mean age = 63.5 years) were evaluated between September 2010 and June 2014. Most 
      lesions were malignant (72.7%). For depth of submucosal invasion, 3-dimensional
      endorectal ultrasound showed sensitivity of 77.3%, specificity of 86.4%, positive
      predictive value of 85.0%, a negative predictive value of 79.2%, and an area
      under curve of 0.82. The weighted kappa coefficient for depth of rectal wall
      invasion staging was 0.67, and there was no agreement between 3-dimensional
      endorectal ultrasound and pathologic diagnosis for lymph node involvement (kappa 
      = -0.164). Intraclass correlation coefficient for lesion extension and percentage
      of rectal circumference involvement were 0.45 and 0.66. A better correlation
      between 3-dimensional endorectal ultrasound and pathologic diagnosis was observed
      in tumors <5 cm and with <50% of rectal wall involvement. LIMITATIONS: The
      relatively small sample size of patients with early rectal lesions referred
      directly for surgery could represent a potential selection bias. CONCLUSIONS:
      Three-dimensional endorectal ultrasound was effective for determining rectal wall
      invasion and lesion extension in tumors <5 cm and with <50% of rectal wall
      invasion but was limited for detecting lymph node involvement in early rectal
FAU - Pinto, Rodrigo Ambar
AU  - Pinto RA
AD  - Department of Gastroenterology, Colorectal Surgery Service, Hospital das Clinicas
      of University of Sao Paulo, School of Medicine, Sao Paulo, Brazil.
FAU - Correa Neto, Isaac Jose Felippe
AU  - Correa Neto IJ
FAU - Nahas, Sergio Carlos
AU  - Nahas SC
FAU - Rizkalah Nahas, Caio Sergio
AU  - Rizkalah Nahas CS
FAU - Sparapan Marques, Carlos Frederico
AU  - Sparapan Marques CF
FAU - Ribeiro Junior, Ulysses
AU  - Ribeiro Junior U
FAU - Kawaguti, Fabio Shiguehissa
AU  - Kawaguti FS
FAU - Cecconello, Ivan
AU  - Cecconello I
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Dis Colon Rectum
JT  - Diseases of the colon and rectum
JID - 0372764
SB  - IM
MH  - Area Under Curve
MH  - Endosonography/*methods
MH  - Female
MH  - Humans
MH  - Imaging, Three-Dimensional/methods
MH  - Lymphatic Metastasis
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - *Peritoneum/diagnostic imaging/pathology
MH  - *Rectal Neoplasms/diagnostic imaging/pathology
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
EDAT- 2017/04/07 06:00
MHDA- 2017/04/19 06:00
CRDT- 2017/04/07 06:00
AID - 10.1097/DCR.0000000000000781 [doi]
AID - 00003453-201705000-00005 [pii]
PST - ppublish
SO  - Dis Colon Rectum. 2017 May;60(5):488-496. doi: 10.1097/DCR.0000000000000781.

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