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Published in: International Journal of Colorectal Disease 3/2006

01-04-2006 | Original Article

Endorectal ultrasound-directed biopsy: a useful technique to detect local recurrence of rectal cancer

Authors: Jeffrey J. Morken, Nancy N. Baxter, Robert D. Madoff, Charles O. Finne III

Published in: International Journal of Colorectal Disease | Issue 3/2006

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Abstract

Aims

This study assesses the value of endorectal ultrasound (ERUS)-directed biopsy in detecting local recurrence of rectal cancer.

Methods

We reviewed the records of patients undergoing ERUS by a single surgeon for surveillance after treatment of rectal adenocarcinoma. Lesions suggestive of local recurrence underwent ERUS-assisted core-needle biopsy (EAB) via a proctoscope after precise ERUS localization or direct ERUS-guided biopsy (EGB) via a B&K Medical probe.

Results

From 1991 to 2003, 525 patients underwent 2,490 surveillance ERUS. Of these patients, 51 underwent 62 biopsy sessions: 36 EGB and 26 EAB. The mean age of patients was 67.2 years (range 38–93 years); 22 (43%) were female. Only 11 patients (22%) had undergone prior radical resection of their primary tumor. No patient experienced a complication from the biopsies despite five being anticoagulated. Of 39 patients whose cancer recurrence was documented during follow-up, 32 (82%) were diagnosed at the initial biopsy session, and in five (13%), recurrence was detected only with ERUS. The combined sensitivity, specificity, and accuracy of EAB and EGB in detecting recurrence was 83, 100, and 87%, respectively. In 26 patients with local recurrence, resection was performed with curative intent.

Conclusion

ERUS with biopsy is useful in detecting local recurrence after treatment of rectal cancer. It is safe, with a high diagnostic yield. It may be particularly useful in patients at higher risk for local recurrence (i.e., after endocavitary radiation and local excision) and may allow early detection of local recurrence, thereby permitting attempts at curative resection.
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Metadata
Title
Endorectal ultrasound-directed biopsy: a useful technique to detect local recurrence of rectal cancer
Authors
Jeffrey J. Morken
Nancy N. Baxter
Robert D. Madoff
Charles O. Finne III
Publication date
01-04-2006
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 3/2006
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-005-0785-7

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