Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_894_Библиотеки_им_академика_М_И_Перельмана.pdf
21 Rectal Carcinoma: Imaging for Staging
381
communication of radiological ndings that
determine patient treatment pathways, in
particular the selection of patients for neoadjuvant therapies. Traditionally, radiology
reports have been issued in ‘free-form’ and
unstanderdised text, based on the radiologist’s
opinion of pertinent staging features. However,
this form of unstructured reporting has been
associated with the omission of crucial prognostic
information such as CRM involvement, both in
histopathology and radiology reports [177, 178].
One solution of enhancing the completeness and
consistency of radiology reports is the use of
synoptic templates that provide summarised
information which various members of the
multidisciplinary team can access and interpret
easily [179]. An example of a MRI based synoptic
reporting proforma with individually itemised
prognostic features, and the option of additional
free text is shown in Fig. 21.13. The
implementation of a such a reporting system at a
population level reported a 39% improvement in
the completeness of pre-operative MRI staging
reports [180]. The use of a synoptic report is one
of the required standards of the new American
College of Surgeons Commission on Cancer
National Accreditation Program for Rectal
Cancer [181]. The American College of
Radiology has been very supportive of this program and has made available a very high quality
educational module about both rectal cancer MRI
staging and the use of synoptic reports [182].
Summary
Advances in imaging technology have revolutionised the way in which rectal cancer is
managed. The remit of accurate pre-operative
staging goes wider than the traditional prognostic stratication of patients. With a complex
range of treatment options available, multidisciplinary teams integrate vital information
from radiological staging with clinical evalua-
Fig. 21.13 Proforma for MRI database
382
M. Dattani and G. Brown
tion to personalise management plans for rectal
cancer patients. MRI remains at the mainstay
of this process; local staging with high resolution images provides critical information about
the tumour and its relation to key anatomical
landmarks, which determine the need or otherwise for neo-adjuvant treatment, the plane and
radicality of curative surgery, and lately, the
possibility of avoiding surgery by assessing the
downstaging response.
Along with emerging technologies, the
improvements in speed and spatial resolution,
development of functional imaging, and the
recognition of novel imaging biomarkers are at
the frontiers of pre-operative rectal cancer
evaluation.
References
1. Wild JJ, Reid JM. Further pilot echographic
studies on the histologic structure of tumors
of the living intact human breast. Am J Pathol.
1952;28(5):839–61.
2. Dragsted J, Gammelgaard J. Endoluminal ultra-
sonic scanning in the evaluation of rectal cancer: a
preliminary report of 13 cases. Gastrointest Radiol.
1983;8(1):367–9.
3. Hildebrandt U, Feifel G. Preoperative staging of
rectal cancer by intrarectal ultrasound. Dis Colon
Rectum. 1958;28(1):42–6.
4. Beynon J, Foy DMA, Temple LN, Channer JL,
Virjee J, Mortensen NJMC.The endosonic appearances of normal colon and rectum. Dis Colon
Rectum. 1986;29(12):810–3.
5. Skandarajah AR, Tjandra JJ. Preoperative loco-
regional imaging in rectal cancer. ANZ J Surg.
2006;76(6):497–504.
6. Harewood GC.Assessment of publication bias in the
reporting of EUS performance in staging rectal cancer. Am J Gastroenterol. 2005;100(4):808–16.
7. Puli SR, Bechtold ML, Reddy JBK, Choudhary A,
Antillon MR, Brugge WR.How good is endoscopic
ultrasound in differentiating various T stages of
rectal cancer? Meta-analysis and systematic review.
Ann Surg Oncol. 2008;16(2):254–65.
8. Bipat S, Glas AS, Slors FJ, Zwinderman AH,
Bossuyt PM, Stoker J.Rectal cancer: local staging
and assessment of lymph node involvement with
endoluminal US, CT, and MR imaging–a meta-analysis. Radiology. 2004;232(3):773–83.
9. Edelman BR, Weiser MR.Endorectal ultrasound: its
role in the diagnosis and treatment of rectal cancer.
Clin Colon Rectal Surg. 2008;21(3):167–77.
10. Hulsmans FJ, Tio TL, Fockens P, Bosma A, Tytgat
GN.Assessment of tumor inltration depth in rectal
cancer with transrectal sonography: caution is necessary. Radiology. 1994;190(3):715–20.
11. Mackay SG, Pager CK, Joseph D, Stewart PJ,
Solomon MJ. Assessment of the accuracy of transrectal ultrasonography in anorectal neoplasia. Br J
Surg. 2003;90(3):346–50.
12. Brown G, Radcliffe AG, Newcombe RG, Dallimore
NS, Bourne MW, Williams GT.Preoperative assessment of prognostic factors in rectal cancer using
high-resolution magnetic resonance imaging. Br J
Surg. 2003;90(3):355–64.
13. Merkel S, Mansmann U, Siassi M, Papadopoulos T,
Hohenberger W, Hermanek P.The prognostic inhomogeneity in pT3 rectal carcinomas. Int J Color Dis.
2001;16(5):298–304.
14. Nielsen LBJ, Wille-Jørgensen P.National and international guidelines for rectal cancer. Color Dis.
2014;16(11):854–65.
15. Akasu T, Kondo H, Moriya Y, Sugihara K, Gotoda
T, Fujita S, etal. Endorectal ultrasonography and
treatment of early stage rectal cancer. World J Surg.
2000;24(9):1061–8.
16. Garcia-Aguilar J, Pollack J, Lee SH, Hernandez de
Anda E, Mellgren A, Wong WD, etal. Accuracy of
endorectal ultrasonography in preoperative staging of
rectal tumors. Dis Colon Rectum. 2002;45(1):10–5.
17. Marusch F, Koch A, Schmidt U, Zippel R, Kuhn R,
Wolff S, etal. Routine use of transrectal ultrasound
in rectal carcinoma: results of a prospective multicenter study. Endoscopy. 2002;34(5):385–90.
18. Manger T, Stroh C.Accuracy of endorectal ultrasonography in the preoperative staging of rectal cancer.
Tech Coloproctol. 2004;8(1):s14–s5.
19. Kauer WK, Prantl L, Dittler HJ, Siewert JR.The
value of endosonographic rectal carcinoma staging in routine diagnostics: a 10-year analysis. Surg
Endosc. 2004;18(7):1075–8.
20. Zammit M, Jenkins JT, Urie A, O'Dwyer PJ,
Molloy RG.A technically difcult endorectal ultrasound is more likely to be inaccurate. Color Dis.
2005;7(5):486–91.
21. Ptok H, Marusch F, Meyer F, Wendling P, Wenisch
HJ, Sendt W, et al. Feasibility and accuracy of
TRUS in the pre-treatment staging for rectal carcinoma in general practice. Eur J Surg Oncol.
2006;32(4):420–5.
22. Badger SA, Devlin PB, Neilly PJ, Gilliland
R. Preoperative staging of rectal carcinoma by
endorectal ultrasound: is there a learning curve? Int
J Color Dis. 2007;22(10):1261–8.
23. Goertz RS, Fein M, Sailer M.Impact of biopsy on
the accuracy of endorectal ultrasound staging of rectal tumors. Dis Colon Rectum. 2008;51(7):1125–9.
24. Morris OJ, Draganic B, Smith S.Does a learning
curve exist in endorectal two-dimensional ultrasound
accuracy? Tech Coloproctol. 2011;15(3):301–11.
25. Marusch F, Ptok H, Sahm M, Schmidt U, Ridwelski
K, Gastinger I, etal. Endorectal ultrasound in rectal carcinoma--do the literature results really correspond to the realities of routine clinical care?
Endoscopy. 2011;43(5):425–31.
21 Rectal Carcinoma: Imaging for Staging
383
26. Ashraf S, Hompes R, Slater A, Lindsey I, Bach S,
Mortensen NJ, etal. A critical appraisal of endorectal ultrasound and transanal endoscopic microsurgery and decision-making in early rectal cancer.
Color Dis. 2012;14(7):821–6.
27. Restivo A, Zorcolo L, Marongiu L, Scintu F, Casula
G. Limits of endorectal ultrasound in tailoring
treatment of patients with rectal cancer. Dig Surg.
2015;32(2):129–34.
28. Orrom WJ, Wong WD, Rothenberger DA,
Jensen LL, Goldberg SM.Endorectal ultrasound
in the preoperative staging of rectal tumors.
A learning experience. Dis Colon Rectum.
1990;33(8):654–9.
29. Li XT, Sun YS, Tang L, Cao K, Zhang XY.Evaluating
local lymph node metastasis with magnetic resonance imaging, endoluminal ultrasound and computed tomography in rectal cancer: a meta-analysis.
Color Dis. 2015;17(6):O129–O35.
30. Kim JC, Kim HC, Yu CS, Han KR, Kim JR, Lee
KH, et al. Efcacy of 3-dimensional endorectal ultrasonography compared with conventional
ultrasonography and computed tomography in
preoperative rectal cancer staging. Am J Surg.
2006;192(1):89–97.
31. Gleeson FC, Clain JE, Papachristou GI, Rajan E,
Topazian MD, Wang KK, et al. Prospective assessment of EUS criteria for lymphadenopathy associated with rectal cancer. Gastrointest Endosc.
2009;69(4):896–903.
32. Catalano MF, Sivak MV Jr, Rice T, Gragg LA,
Van Dam J. Endosonographic features predictive
of lymph node metastasis. Gastrointest Endosc.
1994;40(4):442–6.
33. Harewood GC, Wiersema MJ, Nelson H, Maccarty
RL, Olson JE, Clain JE, etal. A prospective, blinded
assessment of the impact of preoperative staging on
the management of rectal cancer. Gastroenterology.
2002;123(1):24–32.
34. Sailer M, Leppert R, Bussen D, Fuchs KH, Thiede
A. Inuence of tumor position on accuracy of
endorectal ultrasound staging. Dis Colon Rectum.
1997;40(10):1180–6.
35. Taylor FG, Quirke P, Heald RJ, Moran BJ, Blomqvist
L, Swift IR, etal. Preoperative magnetic resonance
imaging assessment of circumferential resection
margin predicts disease-free survival and local recurrence: 5-year follow-up results of the MERCURY
study. J Clin Oncol. 2014;32(1):34–43.
36. Hurlstone DP, Brown S, Cross SS, Shorthouse AJ,
Sanders DS.Endoscopic ultrasound miniprobe staging of colorectal cancer: can management be modied? Endoscopy. 2005;37(08):710–4.
37. Waage JER, Leh S, Røsler C, Pfeffer F, Bach
SP, Havre RF, et al. Endorectal ultrasonography,
strain elastography and MRI differentiation of rectal adenomas and adenocarcinomas. Color Dis.
2015;17(2):124–31.
38. Vliegen RF, Beets GL, von Meyenfeldt MF, Kessels
AG, Lemaire EE, van Engelshoven JM, etal. Rectal
cancer: MR imaging in local staging--is gadolin-
ium-based contrast material helpful? Radiology.
2005;234(1):179–88.
39. Zand KR, Reinhold C, Haider MA, Nakai A,
Rohoman L, Maheshwari S.Artifacts and pitfalls in
MR imaging of the pelvis. J Magn Reson Imaging.
2007;26(3):480–97.
40. Brown G, Richards CJ, Newcombe RG, Dallimore
NS, Radcliffe AG, Carey DP, et al. Rectal carcinoma: thin-section mr imaging for staging in 28
patients. Radiology. 1999;211(1):215–22.
41. Al-Sukhni E, Milot L, Fruitman M, Beyene J,
Victor JC, Schmocker S, etal. Diagnostic accuracy
of MRI for assessment of T category, lymph node
metastases, and circumferential resection margin
involvement in patients with rectal cancer: a systematic review and meta-analysis. Ann Surg Oncol.
2012;19(7):2212–23.
42. Hermanek P, Henson DE, Hutter RV, Sobin
LH.UICC TNM supplement: a commentary on uniform use. Berlin: Springer; 1993.
43. MERCURY Study Group. Extramural depth of
tumor invasion at thin-section MR in patients with
rectal cancer: results of the MERCURY study.
Radiology. 2007;243(1):132–9.
44. Taylor FG, Quirke P, Heald RJ, Moran B,
Blomqvist L, Swift I, et al. Preoperative highresolution magnetic resonance imaging can
identify good prognosis stage I, II, and III rectal
cancer best managed by surgery alone: a prospective, multicenter, European study. Ann Surg.
2011;253(4):711–9.
45. Dworak O. Morphology of lymph nodes in the
resected rectum of patients with rectal carcinoma.
Pathol Res Pract. 1991;187(8):1020–4.
46. Vogl TJ, Pegios W, Mack MG, Hünerbein M, Hintze
R, Adler A, etal. Accuracy of staging rectal tumors
with contrast-enhanced transrectal MR imaging. Am
J Roentgenol. 1997;168(6):1427–34.
47. Blomqvist L, Machado M, Rubio C, Gabrielsson N,
Granqvist S, Goldman S, etal. Rectal tumour staging: MR imaging using pelvic phased-array and
endorectal coils vs endoscopic ultrasonography. Eur
Radiol. 2000;10(4):653–60.
48. Kim NK, Kim MJ, Park JK, Park SI, Min
JS.Preoperative staging of rectal cancer with MRI:
accuracy and clinical usefulness. Ann Surg Oncol.
2000;7(10):732–7.
49. Kim JH, Beets GL, Kim M-J, Kessels AGH,
Beets-Tan RGH. High-resolution MR imaging for nodal staging in rectal cancer: are there
any criteria in addition to the size? Eur J Radiol.
2004;52(1):78–83.
50. Brown G, Richards CJ, Bourne MW, Newcombe
RG, Radcliffe AG, Dallimore NS, etal. Morphologic
predictors of lymph node status in rectal cancer
with use of high-spatial-resolution MR imaging with histopathologic comparison. Radiology.
2003;227(2):371–7.
51. Akasu T, Iinuma G, Takawa M, Yamamoto S,
Muramatsu Y, Moriyama N. Accuracy of highresolution magnetic resonance imaging in preop-
384
M. Dattani and G. Brown
erative staging of rectal cancer. Ann Surg Oncol.
2009;16(10):2787–94.
52. Halefoglu AM, Yildirim S, Avlanmis O, Sakiz
D, Baykan A. Endorectal ultrasonography versus phased-array magnetic resonance imaging
for preoperative staging of rectal cancer. World J
Gastroenterol. 2008;14(22):3504–10.
53. Koh D-M, Brown G, Temple L, Raja A, Toomey P,
Bett N, etal. Rectal cancer: mesorectal lymph nodes
at MR imaging with USPIO versus histopathologic ndings—initial observations. Radiology.
2004;231(1):91–9.
54. Koh DM, George C, Temple L, Collins DJ, Toomey P,
Raja A, etal. Diagnostic accuracy of nodal enhancement pattern of rectal cancer at MRI enhanced with
ultrasmall superparamagnetic iron oxide: ndings
in pathologically matched mesorectal lymph nodes.
AJR Am J Roentgenol. 2010;194(6):W505–13.
55. Lahaye MJ, Engelen SME, Kessels AGH, Bruïne
APD, MFv M, Engelshoven JMAV, et al. USPIOenhanced MR imaging for nodal staging in patients
with primary rectal cancer: predictive criteria.
Radiology. 2008;246(3):804–11.
56. Chand M, Moran BJ, Jones RG, Heald RJ, Brown
G.Lymph node status does not predict local recurrence in the total mesorectal excision era. Dis Colon
Rectum. 2014;57(1):127–9.
57. Kosinski LA, Greene FL.Perfect treatment in an
imperfect world: surgery alone or radiation for
node positive rectal cancer? Dis Colon Rectum.
2014;57(1):130–2.
58. Quirke P, Steele R, Monson J, Grieve R, Khanna
S, Couture J, et al. Effect of the plane of surgery
achieved on local recurrence in patients with operable rectal cancer: a prospective study using data from
the MRC CR07 and NCIC-CTG CO16 randomised
clinical trial. Lancet. 2009;373(9666):821–8.
59. Quirke P, Durdey P, Dixon MF, Williams NS.Local
recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of
lateral tumour spread and surgical excision. Lancet.
1986;2(8514):996–9.
60. Wibe A, Rendedal PR, Svensson E, Norstein J, Eide
TJ, Myrvold HE, et al. Prognostic signicance of
the circumferential resection margin following total
mesorectal excision for rectal cancer. Br J Surg.
2002;89(3):327–34.
61. Nagtegaal ID, Marijnen CA, Kranenbarg EK, van de
Velde CJ, van Krieken JH. Circumferential margin
involvement is still an important predictor of local
recurrence in rectal carcinoma: not one millimeter
but two millimeters is the limit. Am J Surg Pathol.
2002;26(3):350–7.
62. Birbeck KF, Macklin CP, Tifn NJ, Parsons W,
Dixon MF, Mapstone NP, etal. Rates of circumferential resection margin involvement vary between
surgeons and predict outcomes in rectal cancer surgery. Ann Surg. 2002;235(4):449–57.
63. Nagtegaal ID, Quirke P.What is the role for the circumferential margin in the modern treatment of rectal
cancer? J Clin Oncol. 2008;26(2):303–12.
64. Glimelius B, Beets-Tan R, Blomqvist L, Brown
G, Nagtegaal I, Pahlman L, etal. Mesorectal fascia instead of circumferential resection margin in
preoperative staging of rectal cancer. J Clin Oncol.
2011;29(16):2142–3.
65. Park MJ, Kim SH, Lee SJ, Jang KM, Rhim
H. Locally advanced rectal cancer: added value
of diffusion-weighted MR imaging for predicting tumor clearance of the mesorectal fascia after
neoadjuvant chemotherapy and radiation therapy.
Radiology. 2011;260(3):771–80.
66. Beets-Tan RG, Beets GL, Vliegen RF, Kessels AG,
Van Boven H, De Bruine A, etal. Accuracy of magnetic resonance imaging in prediction of tumour-free
resection margin in rectal cancer surgery. Lancet.
2001;357(9255):497–504.
67. Xie H, Zhou X, Zhuo Z, Che S, Xie L, Fu
W. Effectiveness of MRI for the assessment of
mesorectal fascia involvement in patients with rectal
cancer: a systematic review and meta-analysis. Dig
Surg. 2014;31(2):123–34.
68. Taylor FGM, Quirke P, Heald RJ, Moran B,
Blomqvist L, Swift I, et al. One millimetre is the
safe cut-off for magnetic resonance imaging prediction of surgical margin status in rectal cancer. Br J
Surg. 2011;98(6):872–9.
69. Group MS. Diagnostic accuracy of preoperative
magnetic resonance imaging in predicting curative
resection of rectal cancer: prospective observational
study. Br Med J. 2006;333(7572):779.
70. Moriya Y.Treatment of lateral pelvic nodes metastases from rectal cancer: the future prospective. G
Chir. 2013;34(9-10):245–8.
71. Bell S, Sasaki J, Sinclair G, Chapuis PH, Bokey
EL.Understanding the anatomy of lymphatic drainage and the use of blue-dye mapping to determine the
extent of lymphadenectomy in rectal cancer surgery:
unresolved issues. Color Dis. 2009;11(5):443–9.
72. Yano H, Moran BJ. The incidence of lateral pelvic
side-wall nodal involvement in low rectal cancer
may be similar in Japan and the West. Br J Surg.
2008;95(1):33–49.
73. Sugihara K, Kobayashi H, Kato T, Mori T, Mochizuki
H, Kameoka S, etal. Indication and benet of pelvic sidewall dissection for rectal cancer. Dis Colon
Rectum. 2006;49(11):1663–72.
74. Fujita S, Akasu T, Mizusawa J, Saito N, Kinugasa
Y, Kanemitsu Y, et al. Postoperative morbidity and mortality after mesorectal excision with
and without lateral lymph node dissection for
clinical stage II or stage III lower rectal cancer
(JCOG0212): results from a multicentre, randomised controlled, non-inferiority trial. Lancet
Oncol. 2012;13(6):616–21.
75. Georgiou P, Tan E, Gouvas N, Antoniou A,
Brown G, Nicholls RJ, et al. Extended lymphadenectomy versus conventional surgery for
rectal cancer: a meta-analysis. Lancet Oncol.
2009;10(11):1053–62.
76. Kim TH, Jeong S-Y, Choi DH, Kim DY, Jung KH,
Moon SH, et al. Lateral lymph node metastasis is
21 Rectal Carcinoma: Imaging for Staging
385
a major cause of locoregional recurrence in rectal cancer treated with preoperative chemoradiotherapy and curative resection. Ann Surg Oncol.
2007;15(3):729–37.
77. Otowa Y, Yamashita K, Kanemitsu K, Sumi Y,
Yamamoto M, Kanaji S, et al. Treating patients
with advanced rectal cancer and lateral pelvic
lymph nodes with preoperative chemoradiotherapy
based on pretreatment imaging. OncoTargets Ther.
2015;8:3169–73.
78. Shihab OC, Taylor F, Bees N, Blake H, Jeyadevan
N, Bleehen R, et al. Relevance of magnetic resonance imaging-detected pelvic sidewall lymph
node involvement in rectal cancer. Br J Surg.
2011;98(12):1798–804.
79. Freedman LS, Macaskill P, Smith AN.Multivariate
analysis of prognostic factors for operable rectal
cancer. Lancet. 1984;2(8405):733–6.
80. Horn A, Dahl O, Morild I.Venous and neural invasion as predictors of recurrence in rectal adenocarcinoma. Dis Colon Rectum. 1991;34(9):798–804.
81. Talbot IC, Ritchie S, Leighton MH, Hughes AO,
Bussey HJ, Morson BC. The clinical signicance
of invasion of veins by rectal cancer. Br J Surg.
1980;67(6):439–42.
82. Thomson E, Scott N, Tolan D. Re: the prognostic signicance of MRI-detected extramural
venous invasion in rectal carcinoma. Clin Radiol.
2015;70(1):111–2.
83. Bokey EL, Öjerskog B, Chapuis PH, Dent OF,
Newland RC, Sinclair G. Local recurrence after
curative excision of the rectum for cancer without
adjuvant therapy: role of total anatomical dissection.
Br J Surg. 1999;86(9):1164–70.
84. Rich T, Gunderson LL, Lew R, Galdibini JJ,
Cohen AM, Donaldson G. Patterns of recurrence
of rectal cancer after potentially curative surgery.
Cancer. 1983;52(7):1317–29.
85. Courtney ED, West NJ, Kaur C, Ho J, Kalber B,
Hagger R, etal. Extramural vascular invasion is an
adverse prognostic indicator of survival in patients
with colorectal cancer. Color Dis. 2009;11(2):150–6.
86. Betge J, Pollheimer MJ, Lindtner RA, Kornprat P,
Schlemmer A, Rehak P, etal. Intramural and extramural vascular invasion in colorectal cancer. Cancer.
2012;118(3):628–38.
87. Petersen VC, Baxter KJ, Love SB, Shepherd
NA. Identication of objective pathological prognostic determinants and models of prognosis in
Dukes’ B colon cancer. Gut. 2002;51(1):65–9.
88. Chand M, Bhangu A, Wotherspoon A, Stamp GWH,
Swift RI, Chau I, etal. EMVI-positive stage II rectal cancer has similar clinical outcomes as stage III
disease following pre-operative chemoradiotherapy.
Ann Oncol. 2014;25(4):858–63.
89. Chand M, Siddiqui MRS, Swift I, Brown
G. Systematic review of prognostic importance of
extramural venous invasion in rectal cancer. World J
Gastroenterol. 2016;22(4):1721–6.
90. Littleford SE, Baird A, Rotimi O, Verbeke CS,
Scott N. Interobserver variation in the reporting
of local peritoneal involvement and extramural
venous invasion in colonic cancer. Histopathology.
2009;55(4):407–13.
91. Messenger DE, Driman DK, Kirsch R.
Developments in the assessment of venous invasion in colorectal cancer: implications for future
practice and patient outcome. Hum Pathol.
2012;43(7):965–73.
92. Messenger DE, Driman DK, McLeod RS, Riddell
RH, Kirsch R. Current practice patterns among
pathologists in the assessment of venous invasion
in colorectal cancer. J Clin Pathol. 2011;64(11):
983–9.
93. Sternberg A, Amar M, Alci R, Groisman G.
Conclusions from a study of venous invasion in
stage IV colorectal adenocarcinoma. J Clin Pathol.
2002;55(1):17–21.
94. Smith NJ, Shihab O, Arnaout A, Swift RI. Brown
G. MRI for detection of extramural vascular invasion in rectal cancer. AJR Am J Roentgenol.
2008;191(5):1517–22.
95. Smith NJ, Barbachano Y, Norman AR, Swift RI,
Abula AM, Brown G. Prognostic signicance of
magnetic resonance imaging-detected extramural vascular invasion in rectal cancer. Br J Surg.
2008;95(2):229–36.
96. Jhaveri KS, Hosseini-Nik H, Thipphavong S,
Assarzadegan N, Menezes RJ, Kennedy ED, etal.
MRI detection of extramural venous invasion in
rectal cancer: correlation with histopathology using
elastin stain. Am J Roentgenol. 2016;206:1–9.
97. Sohn B, J-s L, Kim H, Myoung S, Choi J, Kim NK,
etal. MRI-detected extramural vascular invasion is
an independent prognostic factor for synchronous
metastasis in patients with rectal cancer. Eur Radiol.
2014;25(5):1347–55.
98. Bugg WG, Andreou AK, Biswas D, Toms AP,
Williams SM. The prognostic signicance of
MRI-detected extramural venous invasion in rectal
carcinoma. Clin Radiol. 2014;69(6):619–23.
99. Nilsson PJ, van Etten B, Hospers GAP, Påhlman
L, van de Velde CJH, Beets-Tan RGH, etal. Shortcourse radiotherapy followed by neo-adjuvant chemotherapy in locally advanced rectal cancer – the
RAPIDO trial. BMC Cancer. 2013;13:279.
100. Salerno G, Sinnatamby C, Branagan G, Daniels IR,
Heald RJ, Moran BJ. Dening the rectum: surgically, radiologically and anatomically. Color Dis.
2006;8:5–9.
101. Moran BJ, Holm T, Brannagan G, Chave H,
Quirke P, West N, et al. The English National
Low Rectal Cancer Development Programme:
key messages and future perspectives. Color Dis.
2014;16(3):173–8.
102. Shihab OC, Moran BJ, Heald RJ, Quirke P, Brown
G. MRI staging of low rectal cancer. Eur Radiol.
2009;19(3):643–50.
103. Battersby NJ, How P, Moran B, Stelzner S, West NP,
Branagan G, etal. Prospective validation of a low
rectal cancer magnetic resonance imaging staging
system and development of a local recurrence risk
386
M. Dattani and G. Brown
stratication model: The MERCURY II study. Ann
Surg. 2016;263(4):751–60.
104. Marr R, Birbeck K, Garvican J, Macklin CP, Tifn
NJ, Parsons WJ, etal. The modern abdominoperineal excision: the next challenge after total mesorectal excision. Ann Surg. 2005;242(1):74–82.
105. den Dulk M, Putter H, Collette L, Marijnen CA,
Folkesson J, Bosset JF, et al. The abdominoperineal resection itself is associated with an adverse
outcome: the European experience based on a
pooled analysis of ve European randomised
clinical trials on rectal cancer. Eur J Cancer.
2009;45(7):1175–83.
106. Nagtegaal ID, van de Velde CJ, Marijnen CA, van
Krieken JH, Quirke P.Low rectal cancer: a call for a
change of approach in abdominoperineal resection. J
Clin Oncol. 2005;23(36):9257–64.
107. Eriksen MT, Wibe A, Syse A, Haffner J, Wiig
JN. Inadvertent perforation during rectal cancer
resection in Norway. Br J Surg. 2004;91(2):210–6.
108. Holm T, Ljung A, Häggmark T, Jurell G, Lagergren
J. Extended abdominoperineal resection with gluteus maximus ap reconstruction of the pelvic oor
for rectal cancer. Br J Surg. 2007;94(2):232–8.
109. Foster JD, Pathak S, Smart NJ, Branagan G,
Longman RJ, Thomas MG, etal. Reconstruction of
the perineum following extralevator abdominoperineal excision for carcinoma of the lower rectum: a
systematic review. Color Dis. 2012;14(9):1052–9.
110. West NP, Anderin C, Smith KJ, Holm T, Quirke
P.Multicentre experience with extralevator abdominoperineal excision for low rectal cancer. Br J Surg.
2010;97(4):588–99.
111. Salerno G, Daniels I, Heald RJ, Brown G, Moran
BJ. Management and imaging of low rectal carcinoma. Surg Oncol. 2004;13(2–3):55–61.
112. Shihab OC, Heald RJ, Rullier E, Brown G, Holm
T, Quirke P, et al. Dening the surgical planes on
MRI improves surgery for cancer of the low rectum.
Lancet Oncol. 2009;10(12):1207–11.
113. Salerno GV, Daniels IR, Moran BJ, Heald RJ,
Thomas K, Brown G. Magnetic resonance imaging prediction of an involved surgical resection
margin in low rectal cancer. Dis Colon Rectum.
2009;52(4):632–9.
114. Beyond TME Collaborative. Consensus statement on the multidisciplinary management of
patients with recurrent and primary rectal cancer
beyond total mesorectal excision planes. Br J Surg.
2013;100(8):1009–14.
115. Bhangu A, Ali SM, Brown G, Nicholls RJ, Tekkis
P.Indications and outcome of pelvic exenteration for
locally advanced primary and recurrent rectal cancer. Ann Surg. 2014;259(2):315–22.
116. Georgiou PA, Tekkis PP, Constantinides VA, Patel
U, Goldin RD, Darzi AW, etal. Diagnostic accuracy
and value of magnetic resonance imaging (MRI) in
planning exenterative pelvic surgery for advanced
colorectal cancer. Eur J Cancer. 2013;49(1):72–81.
117. Balyasnikova S, Brown G. Imaging advances in
colorectal cancer. Curr Colorectal Cancer Rep.
2016;12:162–9.
118. Sebag-Monteore D, Stephens RJ, Steele R, Monson
J, Grieve R, Khanna S, etal. Preoperative radiotherapy versus selective postoperative chemoradiotherapy in patients with rectal cancer (MRC CR07 and
NCIC-CTG C016): a multicentre, randomised trial.
Lancet. 2009;373(9666):811–20.
119. van Gijn W, Marijnen CA, Nagtegaal ID, Kranenbarg
EM, Putter H, Wiggers T, etal. Preoperative radiotherapy combined with total mesorectal excision
for resectable rectal cancer: 12-year follow-up of
the multicentre, randomised controlled TME trial.
Lancet Oncol. 2011;12(6):575–82.
120. Bosset J-F, Collette L, Calais G, Mineur L, Maingon
P, Radosevic-Jelic L, etal. Chemotherapy with preoperative radiotherapy in rectal cancer. N Engl J
Med. 2006;355(11):1114–23.
121. Gérard J-P, Conroy T, Bonnetain F, Bouché O,
Chapet O, Closon-Dejardin M-T, etal. Preoperative
radiotherapy with or without concurrent uorouracil and leucovorin in T3-4 rectal cancers:
results of FFCD 9203. J Clin Oncol. 2006;24(28):
4620–5.
122. Battersby NJ, Juul T, Christensen P, Janjua AZ,
Branagan G, Emmertsen KJ, et al. Predicting the
risk of bowel-related quality-of-life impairment
after restorative resection for rectal cancer: a multicenter cross-sectional study. Dis Colon Rectum.
2016;59(4):270–80.
123. Marijnen CA, Kapiteijn E, van de Velde CJ, Martijn
H, Steup WH, Wiggers T, etal. Acute side effects
and complications after short-term preoperative
radiotherapy combined with total mesorectal excision in primary rectal cancer: report of a multicenter
randomized trial. J Clin. 2002;20(3):817–25.
124. Birgisson H, Pahlman L, Gunnarsson U, Glimelius
B.Occurrence of second cancers in patients treated
with radiotherapy for rectal cancer. J Clin Oncol.
2005;23(25):6126–31.
125. Morris EJ, Finan PJ, Spencer K, Geh I, Crellin A,
Quirke P, et al. Wide variation in the use of radiotherapy in the management of surgically treated
rectal cancer across the English National Health
Service. Clin Oncol. 2016;22:522–31.
126. Fitzgerald TL, Zervos E, Wong JH.Patterns of pelvic radiotherapy in patients with stage II/III rectal
cancer. J Cancer Epidemiol. 2013;2013:408460.
127. van Leersum NJ, Snijders HS, Wouters MWJM,
Henneman D, Marijnen CAM, Rutten HR, et al.
Evaluating national practice of preoperative radiotherapy for rectal cancer based on clinical auditing.
Eur J Surg Oncol. 2013;39(9):1000–6.
128. Gunderson LL, Sargent DJ, Tepper JE, Wolmark N,
O'Connell MJ, Begovic M, etal. Impact of T and N
stage and treatment on survival and relapse in adjuvant rectal cancer: a pooled analysis. J Clin Oncol.
2004;22(10):1785–96.
21 Rectal Carcinoma: Imaging for Staging
387
129. Lai LL, Fuller CD, Kachnic LA, Thomas CR Jr.
Can pelvic radiotherapy be omitted in select patients
with rectal cancer? Semin Oncol. 2006;33(6 Suppl
11):S70–4.
130. Glynne-Jones R, Tan D, Goh V.Pelvic MRI for guiding treatment decisions in rectal cancer. Oncology.
2014;28(8):667–77.
131. Benson AB, Bekaii-Saab T, Chan E, Chen Y-J, Choti
MA, Cooper HS, etal. Rectal cancer. J Natl Compr
Cancer Netw. 2012;10(12):1528–64.
132. Guillem JG, Díaz-González JA, Minsky BD,
Valentini V, Jeong S-Y, Rodriguez-Bigas MA, etal.
cT3N0 rectal cancer: potential overtreatment with
preoperative chemoradiotherapy is warranted. J Clin
Oncol. 2008;26(3):368–73.
133. Sautter-Bihl M-L, Hohenberger W, Fietkau R,
Roedel C, Schmidberger H, Sauer R. MRI-based
treatment of rectal cancer: is prognostication of
the recurrence risk solid enough to render radiation
redundant? Ann Surg Oncol. 2014;21(1):197–204.
134. Smith N, Brown G. Preoperative staging of rectal
cancer. Acta Oncol. 2008;47(1):20–31.
135. Blomqvist L, Glimelius B.The ‘good’, the ‘bad’, and
the ‘ugly’ rectal cancers. Acta Oncol. 2008;47(1):5–8.
136. Colorectal cancer: diagnosis and management
[CG131]. National Institute for Health and Clinical
Excellence. 2011(November).
137. Glimelius B, Tiret E, Cervantes A, Arnold D, Group
obotEGW. Rectal cancer: ESMO clinical practice
guidelines for diagnosis, treatment and follow-up.
Ann Oncol. 2013;24(suppl 6):vi81–8.
138. Valentini V, Glimelius B, Haustermans K,
Marijnen CAM, Rödel C, Gambacorta MA, etal.
EURECCA consensus conference highlights about
rectal cancer clinical management: The radiation oncologist’s expert review. Radiother Oncol.
2014;110(1):195–8.
139. Glimelius B. Optimal time intervals between preoperative radiotherapy or chemoradiotherapy and
surgery in rectal cancer? Front Oncol. 2014;4:50.
140. Memon S, Lynch AC, Bressel M, Wise AG, Heriot
AG. Systematic review and meta-analysis of the
accuracy of MRI and endorectal ultrasound in the
restaging and response assessment of rectal cancer following neoadjuvant therapy. Color Dis.
2015;17(9):748–61.
141. Hanly AM, Ryan EM, Rogers AC, McNamara
DA, Madoff RD, Winter DC. Multicenter evaluation of rectal cancer reimaging post neoadjuvant (MERRION) therapy. Ann Surg.
2014;259(4):723–7.
142. Glynne-Jones R, Wallace M, Livingstone JIL,
Meyrick-Thomas J.Complete clinical response after
preoperative chemoradiation in rectal cancer: is a
“wait and see” policy justied? Dis Colon Rectum.
2007;51(1):10–20.
143. Marijnen CAM.Organ preservation in rectal cancer:
have all questions been answered? Lancet Oncol.
2015;16(1):e13–22.
144. Eisenhauer EA, Therasse P, Bogaerts J, Schwartz
LH, Sargent D, Ford R, et al. New response
evaluation criteria in solid tumours: revised
RECIST guideline (version 1.1). Eur J Cancer.
2009;45(2):228–47.
145. Evans J, Patel U, Brown G.Rectal cancer: primary
staging and assessment after chemoradiotherapy.
Semin Radiat Oncol. 2011;21(3):169–77.
146. Minocha J, Lewandowski RJ. Assessing imaging response to therapy. Radiol Clin N Am.
2015;53(5):1077–88.
147. Zhao RS, Wang H, Zhou ZY, Zhou Q, Mulholland
MW. Restaging of locally advanced rectal cancer
with magnetic resonance imaging and endoluminal
ultrasound after preoperative chemoradiotherapy:
a systemic review and meta-analysis. Dis Colon
Rectum. 2014;57(3):388–95.
148. de Jong EA, ten Berge JCEM, Dwarkasing RS,
Rijkers AP, van Eijck CHJ.The accuracy of MRI,
endorectal ultrasonography, and computed tomography in predicting the response of locally advanced
rectal cancer after preoperative therapy: a metaanalysis. Surgery. 2016;159(3):688–99.
149. Pierredon-Foulongne MA, Nougaret S, Bibeau F,
Rouanet P, Delhom E, Lonjon J, et al. Utility of
reassessment after neoadjuvant therapy and difculties in interpretation. Diagn Interv Imaging.
2014;95(5):495–503.
150. Tanaka S, Martling A, Lindholm J, Holm T, Palmer
G. Remaining cancer cells within the brosis
after neo-adjuvant treatment for locally advanced
rectal cancer. Eur J Surg Oncol. 2015;41(9):
1204–9.
151. Chand M, Evans J, Swift RI, Tekkis PP, West NP,
Stamp G, etal. The prognostic signicance of postchemoradiotherapy high-resolution MRI and histopathology detected extramural venous invasion in
rectal cancer. Ann Surg. 2015;261(3):473–9.
152. Chand M, Swift RI, Tekkis PP, Chau I, Brown
G.Extramural venous invasion is a potential imaging predictive biomarker of neoadjuvant treatment in
rectal cancer. Br J Cancer. 2014;110(1):19–25.
153. Dattani M, Moran BJ. Watch and wait after neoadjuvant therapy for rectal cancer. Br J Surg.
2016;103:629–31.
154. Habr-Gama A, Perez RO, Nadalin W, Sabbaga J,
Ribeiro U, Silva e Sousa AH, etal. Operative versus nonoperative treatment for stage 0 distal rectal
cancer following chemoradiation therapy: long-term
results. Ann Surg. 2004;240(4):711–8.
155. Smith JD, Ruby JA, Goodman KA, Saltz LB,
Guillem JG, Weiser MR, et al. Nonoperative management of rectal cancer with complete clinical
response after neoadjuvant therapy. Ann Surg.
2012;256(6):965–72.
156. Renehan AG, Malcomson L, Emsley R, Gollins S,
Maw A, Myint AS, et al. Watch-and-wait approach
versus surgical resection after chemoradiotherapy
for patients with rectal cancer (the OnCoRe project):
388
M. Dattani and G. Brown
a propensity-score matched cohort analysis. Lancet
Oncol. 2015;17:174–83.
157. Appelt AL, Pløen J, Harling H, Jensen FS, Jensen
LH, Jørgensen JCR, et al. High-dose chemoradiotherapy and watchful waiting for distal rectal cancer:
a prospective observational study. Lancet Oncol.
2015;16(8):919–27.
158. Martens MH, Maas M, Heijnen LA, Lambregts DM,
Leijtens JW, Stassen LP, et al. Long-term outcome
of an organ preservation program after neoadjuvant treatment for rectal cancer. J Natl Cancer Inst.
2016;108(12):djw171.
159. Maas M, Lambregts DMJ, Nelemans PJ, Heijnen
LA, Martens MH, Leijtens JWA, et al. Assessment
of clinical complete response after chemoradiation for rectal cancer with digital rectal
examination, endoscopy, and MRI: selection for organsaving treatment. Ann Surg Oncol. 2015;22(12):
3873–80.
160. Bhoday J, Smith F, Siddiqui MR, Balyasnikova S,
Swift RI, Perez R, etal. Magnetic resonance tumor
regression grade and residual mucosal abnormality
as predictors for pathological complete response in
rectal cancer postneoadjuvant chemoradiotherapy.
Dis Colon Rectum. 2016;59(10):925–33.
161. Mandard AM, Dalibard F, Mandard JC, Marnay
J, Henry-Amar M, Petiot JF, et al. Pathologic
assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer.
1994;73(11):2680–6.
162. Patel UB, Taylor F, Blomqvist L, George C, Evans
H, Tekkis P, et al. Magnetic resonance imaging–
detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY
experience. J Clin Oncol. 2011;29(28):3753–60.
163. Joye I, Deroose CM, Vandecaveye V, Haustermans
K. The role of diffusion-weighted MRI and (18)
F-FDG PET/CT in the prediction of pathologic
complete response after radiochemotherapy for rectal cancer: a systematic review. Radiother Oncol.
2014;113(2):158–65.
164. Cunningham D, Atkin W, Lenz HJ, Lynch HT,
Minsky B, Nordlinger B, et al. Colorectal cancer.
Lancet. 2010;375(9719):1030–47.
165. Mantke R, Schmidt U, Wolff S, Kube R, Lippert
H. Incidence of synchronous liver metastases in
patients with colorectal cancer in relationship to
clinico-pathologic characteristics. Results of a
German prospective multicentre observational study.
Eur J Surg Oncol. 2012;38(3):259–65.
166. Mitry E, Guiu B, Cosconea S, Jooste V, Faivre
J, Bouvier AM. Epidemiology, management and
prognosis of colorectal cancer with lung metastases: a 30-year population-based study. Gut.
2010;59(10):1383–8.
167. Mirnezami R, Mehta AM, Chandrakumaran K,
Cecil T, Moran BJ, Carr N, etal. Cytoreductive sur-
gery in combination with hyperthermic intraperitoneal chemotherapy improves survival in patients
with colorectal peritoneal metastases compared
with systemic chemotherapy alone. Br J Cancer.
2014;111(8):1500–8.
168. Niekel MC, Bipat S, Stoker J.Diagnostic imaging
of colorectal liver metastases with CT, MR imaging,
FDG PET, and/or FDG PET/CT: a meta-analysis
of prospective studies including patients who have
not previously undergone treatment. Radiology.
2010;257(3):674–84.
169. Knowles B, Welsh FK, Chandrakumaran K, John TG,
Rees M.Detailed liver-specic imaging prior to preoperative chemotherapy for colorectal liver metastases reduces intra-hepatic recurrence and the need for
a repeat hepatectomy. HPB. 2012;14(5):298–309.
170. Dewhurst C, Rosen MP, Blake MA, Baker ME, Cash
BD, Fidler JL, et al. ACR appropriateness criteria
pretreatment staging of colorectal cancer. J Am Coll
Radiol. 2012;9(11):775–81.
171. Vatandoust S, Price TJ, Karapetis CS. Colorectal
cancer: metastases to a single organ. World J
Gastroenterol. 2015;21(41):11767–76.
172. Nordholm-Carstensen A, Wille-Jorgensen PA,
Jorgensen LN, Harling H.Indeterminate pulmonary
nodules at colorectal cancer staging: a systematic
review of predictive parameters for malignancy. Ann
Surg Oncol. 2013;20(12):4022–30.
173. Bamba Y, Itabashi M, Kameoka S. Value of PET/
CT imaging for diagnosing pulmonary metastasis of colorectal cancer. Hepato-Gastroenterology.
2011;58(112):1972–4.
174. Koh J-L, Yan TD, Glenn D, Morris DL.Evaluation
of preoperative computed tomography in estimating peritoneal cancer index in colorectal
peritoneal carcinomatosis. Ann Surg Oncol.
2009;16(2):327–33.
175. Esquivel J, Chua TC, Stojadinovic A, Melero JT,
Levine EA, Gutman M, etal. Accuracy and clinical
relevance of computed tomography scan interpretation of peritoneal cancer index in colorectal cancer peritoneal carcinomatosis: a multi-institutional
study. J Surg Oncol. 2010;102(6):565–70.
176. Iversen LH, Rasmussen PC, Laurberg S. Value
of laparoscopy before cytoreductive surgery
and hyperthermic intraperitoneal chemotherapy for peritoneal carcinomatosis. Br J Surg.
2013;100(2):285–92.
177. Bull AD, Bifn AH, Mella J, Radcliffe AG,
Stamatakis JD, Steele RJ, et al. Colorectal cancer
pathology reporting: a regional audit. J Clin Pathol.
1997;50(2):138–42.
178. Taylor F, Mangat N, Swift IR, Brown G.Proformabased reporting in rectal cancer. Cancer Imaging.
2010;10:S142–50.
179. Spiegle G, Leon-Carlyle M, Schmocker S, Fruitman
M, Milot L, Gagliardi AR, etal. Development of
21 Rectal Carcinoma: Imaging for Staging
389
a synoptic MRI report for primary rectal cancer.
Implement Sci. 2009;4:79.
180. Kennedy ED, Milot L, Fruitman M, Al-Sukhni
E, Heine G, Schmocker S, et al. Development
and implementation of a synoptic MRI report
for preoperative staging of rectal cancer on
a population-based level. Dis Colon Rectum.
2014;57(6):700–8.
181. National Accreditation Program for Rectal Cancer,
American College of Surgeons, https://www.facs.
org/quality-programs/cancer/naprc.
182. ACR Catalog, Rectal Cancer Staging, https://
shop.acr.org/Default.aspx?TabID=55&Product
Id=1753677070.
Rectal Carcinoma: Operative Treatment, Transanal
CoraIaniro, MarkH.Whiteford, andPatriciaSylla
22
Local Approaches to Rectal Cancer
The history of rectal cancer surgery is intertwined
with both radical transabdominal approaches and
non-radical local approaches. In 1886, Kraske
described the transsacral approach to low and mid
rectal cancers [1]. This procedure was able to
access tumors that were either too large or beyond
the of reach for transanal approaches and permitted adequate visability for both disc excisions and
more extensive sleeve resections. The procedure
was initially performed as a two-step process with
a midline to left gluteal skin incision with distal
sacrococcygectomy and division of the levator
muscles in the right lateral decubitus position, followed by the rectal excision in lithotomy position
[2]. Unfortunately, when applied to all comers,
this operation suffered from unacceptably high
incidence of local recurrence (~90%), fecal stula
C. Ianiro
Department of Surgery, Division of Colorectal
Surgery, Mount Sinai Hospital, New York, NY, USA
e-mail: cora.ianiro@mountsinai.org
M. H. Whiteford
Oregon Health and Science University,
Portland, OR, USA
e-mail: mwhiteford@orclinic.com
P. Sylla (*)
Department of Surgery, Division of Colorectal
Surgery, Mount Sinai Hospital, New York, NY, USA
Icahn School Medicine, New York, NY, USA
e-mail: patricia.sylla@mountsinai.org
(~70%). The transsacral approach evolved to a
single stage prone jack-knife procedure, and when
applied to a more select population of early rectal
cancers and polyps, had a lower, but still signicant fecal stula rate of approximately 20% [2]. A
second dorsal approach was popularized by
Mason. Through a similar posterior incision, the
sacrum and coccyx are spared, but rectal access
was facilitated by careful division of the sphincter
complex in the midline to fully lay open the rectum from anusup [3]. This was followed by careful reapproximation of the sphincter during
closure. Concerns over increased fecal incontinence and fecal stulas halted enthusiasm for this
technique. The successes of local excision via
transanal surgery and TME with stapled or hand
sewn anastomosis have supplanted the routine
need for dorsal approaches for rectal polyps and
cancer. The dorsal approaches are still utilized for
less common indications such as removal of distal
presacral tumors and to repair iatrogenic rectourinary stulas [4, 5].
Prior to adoption of low pelvic stapling
devices, dorsal approaches, in conjunction with a
synchronous abdominal approach, was utilized
for the radical treatment of mid rectal tumors
with sphincter preservation. Patients were positioned in a right lateral [6, 7]. These techniques
had acceptable oncological and functional results
and a fecal stula rate of 10%, which usually
resolved spontaneously or with temporary fecal
diversion.
© Springer International Publishing AG, part of Springer Nature 2019
D. E. Beck et al. (eds.), Fundamentals of Anorectal Surgery,
https://doi.org/10.1007/978-3-319-65966-4_22
391