scholarly journals Intra- and Interobserver Variability in Magnetic Resonance Imaging Measurements in Rectal Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (20) ◽  
pp. 5120
Author(s):  
Peter Grimm ◽  
Martina Kastrup Loft ◽  
Claus Dam ◽  
Malene Roland Vils Pedersen ◽  
Signe Timm ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Staging ◽  
Kappa Statistics ◽  
Intraobserver Variability ◽  
Intraobserver Agreement ◽  
Round Shape ◽  
Irregular Border ◽  
Node Location

Colorectal cancer is the second most common cancer in Europe, and accurate lymph node staging in rectal cancer patients is essential for the selection of their treatment. MRI lymph node staging is complex, and few studies have been published regarding its reproducibility. This study assesses the inter- and intraobserver variability in lymph node size, apparent diffusion coefficient (ADC) measurements, and morphological characterization among inexperienced and experienced radiologists. Four radiologists with different levels of experience in MRI rectal cancer staging analyzed 36 MRI scans of 36 patients with rectal adenocarcinoma. Inter- and intraobserver variation was calculated using interclass correlation coefficients and Cohens-kappa statistics, respectively. Inter- and intraobserver agreement for the length and width measurements was good to excellent, and for that of ADC it was fair to good. Interobserver agreement for the assessment of irregular border was moderate, heterogeneous signal was fair, round shape was fair to moderate, and extramesorectal lymph node location was moderate to almost perfect. Intraobserver agreement for the assessment of irregular border was fair to substantial, heterogeneous signal was fair to moderate, round shape was fair to moderate, and extramesorectal lymph node location was substantial to almost perfect. Our data indicate that subjective variables such as morphological characteristics are less reproducible than numerical variables, regardless of the level of experience of the observers.

PO-1111: Pathological lymph node staging for intermediate-risk rectal cancer patients

2020 ◽  
Vol 152 ◽  
pp. S587
Author(s):  
A. Biche ◽  
A. Choudhury ◽  
L. Wee ◽  
A. Dekker ◽  
J. Van Soest ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Staging ◽  
Intermediate Risk

Clinical lymph node staging by imaging in colorectal cancer: A flip of the coin?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15160-e15160 ◽  
Author(s):  
Nelleke Pietronella Maria Brouwer ◽  
Rutger Carel Hubert Stijns ◽  
Lemmens Valery ◽  
Iris D. Nagtegaal ◽  
Regina GH Beets-Tan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Lymph Node Staging ◽  
Preoperative Treatment ◽  
Positive Lymph Nodes

e15160 Background: Clinical lymph node staging by MRI and CT is important in stratification for neoadjuvant therapy in colorectal cancer. Overstaging may result in unnecessary neoadjuvant therapy, but understaging may refrain patients from adequate preoperative treatment. This study aims to provide insight in current daily practice in clinical lymph node staging in CRC in the Netherlands. Methods: All patients with primary CRC, diagnosed between 2003-2014, who underwent lymph node dissection were selected from the nationwide population-based Netherlands Cancer Registry (n=100,211). Trends in patient- and tumor-characteristics, and lymph node staging were analyzed. For the years 2011-2014, sensitivity, specificity, positive (PPV) and negative predictive value (NPV) were calculated for clinical lymph node staging, with histology as the gold standard. Only patients without preoperative treatment were analyzed. Since prospective studies have shown that 5x5 Gy radiotherapy (RT) followed by total mesorectal excision within 10 days does not lead to nodal downstaging, an additional analysis was performed in this group. Results: The proportion clinically positive lymph nodes increased significantly between 2003-2014; from 7% to 22% for colon cancer and from 7% to 53% for rectal cancer. The proportion histological positive lymph nodes remained fairly stable over time (±35% colon, ±33% rectum). During 2011-2014, clinical lymph node staging was available in the registry in 86% of colon cancer patients, 92% of rectal cancer patients without neoadjuvant treatment and 95% of rectal cancer patients with 5x5 Gy RT. The parameters based on data from this period are presented in table 1. Conclusions: With a sensitivity and PPV of approximately 50%, clinical lymph node staging is about as accurate as flipping a coin. This leads to overtreatment in patients with rectal cancer with neoadjuvant RT. Acceptable specificity and NPV limit the risk of undertreatment. [Table: see text]

MRI for rectal cancer: Staging, mrCRM, EMVI, lymph node staging and post-treatment response

2021 ◽  
Author(s):  
David D.B. Bates ◽  
Maria El Homsi ◽  
Kevin Chang ◽  
Neeraj Lalwani ◽  
Natally Horvat ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Treatment Response ◽  
Cancer Staging ◽  
Post Treatment ◽  
Lymph Node Staging ◽  
Rectal Cancer Staging

Isolated tumor cell in lateral lymph node has no influences on the prognosis of rectal cancer patients

2007 ◽  
Vol 22 (8) ◽  
pp. 911-917 ◽  
Author(s):  
M. Hara ◽  
T. Hirai ◽  
H. Nakanishi ◽  
Y. Kanemitsu ◽  
K. Komori ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Tumor Cell ◽  
Cancer Patients ◽  
Lateral Lymph Node ◽  
Isolated Tumor Cell

Advanced Lymph Node Staging with Ex Vivo Intraarterial Indigo Carmine Injection after Transanal Total Mesorectal Excision for Rectal Cancer

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Bernhard Widmann ◽  
Bassel Almarie ◽  
Rene Warschkow ◽  
Ulrich Beutner ◽  
Michael Weitzendorfer ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Node ◽  
Total Mesorectal Excision ◽  
Ex Vivo ◽  
Indigo Carmine ◽  
Lymph Node Staging ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision

scholarly journals Clinicopathological Factors Influencing Lymph Node Yield in Colorectal Cancer: A Retrospective Study

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Elena Orsenigo ◽  
Giulia Gasparini ◽  
Michele Carlucci
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Rank Test ◽  
Lymph Node Yield ◽  
Log Rank Test ◽  
Lymph Node Retrieval

Many colorectal resections do not meet the minimum of 12 lymph nodes (LNs) recommended by the American Joint Committee on Cancer for accurate staging of colorectal cancer. The aim of this study was to investigate factors affecting the number of the adequate nodal yield in colorectal specimens subject to routine pathological assessment. We have retrospectively analysed the data of 2319 curatively resected colorectal cancer patients in San Raffaele Scientific Institute, Milan, between 1993 and 2017 (1259 colon cancer patients and 675 rectal cancer patients plus 385 rectal cancer patients who underwent neoadjuvant therapy). The factors influencing lymph node retrieval were subjected to uni- and multivariate analyses. Moreover, a survival analysis was carried out to verify the prognostic implications of nodal counts. The mean number of evaluated nodes was 24.08±11.4, 20.34±11.8, and 15.33±9.64 in surgically treated right-sided colon cancer, left-sided colon cancer, and rectal tumors, respectively. More than 12 lymph nodes were reported in surgical specimens in 1094 (86.9%) cases in the colon cohort and in 425 (63%) cases in the rectal cohort, and patients who underwent neoadjuvant chemoradiation were analysed separately. On univariate analysis of the colon cancer group, higher LNs counts were associated with female sex, right colon cancer, emergency surgery, pT3-T4 diseases, higher tumor size, and resected specimen length. On multivariate analysis right colon tumors, larger mean size of tumor, length of specimen, pT3-T4 disease, and female sex were found to significantly affect lymph node retrieval. Colon cancer patients with 12 or more lymph nodes removed had a significantly better long-term survival than those with 11 or fewer nodes (P=0.002, log-rank test). Rectal cancer patients with 12 or more lymph nodes removed approached but did not reach a statistically different survival (P=0.055, log-rank test). Multiple tumor and patients’ factors are associated with lymph node yield, but only the removal of at least 12 lymph nodes will reliably determine lymph node status.

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