AIM: To evaluate accuracy of endorectal ultrasonography (ERUS) both in staging and restaging rectal cancer after neoadjuvant
chemoradiotherapy treatment.
METHODS: In a group of 80 patients with rectal cancer, we retrospectively selected 67 patients and divided in two
groups: 41 patients affected by a stage I were investigated with a single preoperative endorectal sonography; 26 patients
with locally advanced rectal cancer (stage II or more) were restaged after neoadjuvant treatment, which consisted of
5,040 cGy in 28 daily fractions associated with continuous infusion of 5-Fluorouracil. All patients underwent surgery
and ERUS findings were subsequently compared with histological findings.
RESULTS: Diagnostic accuracy of ERUS in the first group of patients was high: in fact T-staging was accurate in 85%
of cases. Results in the second group were significantly less accurate, with a correct T-staging just for 47% of cases. Nodes
involvement was correctly evaluated in 86% of cases for the first group and in 63% of cases for the second one.
CONCLUSIONS: Endorectal sonography is a valid staging modality for early rectal malignancy. Advanced cancer is treated
with neoadjuvant preoperative chemoradiotherapy which is associated with better outcome than postoperative treatment.
We found endorectal sonography, based on the layer model of rectal wall, often fails restaging and we think we
have to develop new criteria for a correct preoperative assessment after neoadjuvant chemoradiation
