Kazi M, Nekkanti SS, Rohila J, Patel S, Sukumar V, Desouza A, Saklani A. Impact of surgical staging for aggressive histology rectal cancers: a retrospective review.
ANZ J Surg 2020;
91:E119-E122. [PMID:
33377582 DOI:
10.1111/ans.16496]
[Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/25/2020] [Accepted: 11/28/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND
Poorly differentiated adenocarcinomas and signet ring adenocarcinomas are aggressive histological subtypes of rectal cancer with a high incidence of occult peritoneal metastasis.
METHODS
This was a retrospective review of aggressive histology of rectal cancer patients who underwent pre-treatment surgical staging as part of ovarian transposition or ostomy creation for diversion at a single tertiary cancer centre between January 2014 and December 2019.
RESULTS
A total of 117 patients underwent surgical staging and were deemed non-metastatic on imaging. Surgical staging led to the detection of metastasis in 29.9% of patients. This led to modification in treatment protocol in 20.5% and change in intent of therapy in 15.4%. The majority (80%) was found to have peritoneal disease with peritoneal carcinomatosis index <17. Only T4 disease predicted the presence of metastasis on surgical staging with an odds ratio of 2.69 (P = 0.035).
CONCLUSIONS
A significant proportion of patients with aggressive histology rectal cancers are upstaged after surgical staging. Further investigation of this tool for staging is warranted.
Collapse