Pronostique de l’Écho-Endoscopie dans le Cancer
du Rectum: Résultats d’une Analyse Multifactorielle
Radu Seicean1, Andrada Seicean2,
Pascal Burtin3, Jean-Pierre Arnaud4, Marie-Christine Rousselet5,
Patrice Cellier6, Philippe Dubois7, Jean Boyer3
1. Clinique Chirurgicale
I. 2. Clinique Médicale III, Cluj-Napoca. 3. Service
de Médecine A. 4. Service de Chirurgie Viscérale.
5. Service d’Anatomie Pathologique, Centre Hospitalier
et Universitaire. 6. Centre Paul Papin, Angers, France
No study has evaluated the prognostic value of initial endorectal
ultrasonography (ERUS) in rectal cancer (RC).
assess the prognostic value of initial ERUS in operated patients
Material and methods.
Eighty-four patients with non metastatic RC were examined by
ERUS before treatment. Forty-two received preoperative radiation
therapy and they were resected 7 weeks later on average. The
prognostic value of uTN and pTN classification was analysed
by means of a Cox model, taking into account the realization
of preoperative radiation therapy.
In the univariate analysis, 4 variables were predictive of prognosis:
elevation of alkaline phosphatases, the degree of circonference,
the extension of the resection margin, and the involvement of
perirectal lymph nodes. The multivariate analysis showed that
when considering only pTN and uTN classifications, only uT and
pN kept a significant prognostic value. The better prognostic
role of uT was due to a close relationship with preoperative
radiation therapy which was responsible for a significant downstaging.
Since preoperative radiotherapy has become a standard in France,
the prognostic value of ERUS has emerged, better than pTN classification
when radiotherapy has been preoperatively applied. Other prognostic
factors should be investigated in a more homogeneous population
of patients, all presurgically irradiated.
Rectal cancer - staging
- endorectal ultrasonography