Details

Autor(en) / Beteiligte

• Fernández-Esparrach, Gloria
• Alberghina, Nadia
• Subtil, José Carlos
• Vázquez-Sequeiros, Enrique
• Florio, Vivian
• Zozaya, Francisco
• Araujo, Isis
• Ginès, Angels

Titel

Endoscopic Ultrasound-Guided Fine Needle Aspiration Is Highly Accurate for the Diagnosis of Perirectal Recurrence of Colorectal Cancer

Ist Teil von

• Diseases of the colon & rectum, 2015-05, Vol.58 (5), p.469-473

Ort / Verlag

United States: The American Society of Colon and Rectal Surgeons

Erscheinungsjahr

2015

Quelle

MEDLINE

Beschreibungen/Notizen

• BACKGROUND:Endoscopic ultrasound-guided fine needle aspiration is highly accurate for the diagnosis of malignancies surrounding the gastrointestinal tract. There is a lack of information on the usefulness of this technique in the diagnosis of colorectal cancer recurrence. OBJECTIVE:The purpose of this work was to investigate the performance characteristics of endoscopic ultrasound-guided fine needle aspiration for the cytologic diagnosis of perirectal recurrence of colorectal cancer. DESIGN:This was a retrospective study on the clinical and radiologic suspicion of perirectal recurrence of colorectal cancer. SETTINGS:The study was conducted at 4 tertiary hospitals. PATIENTS:Consecutive patients with suspicion of perirectal recurrence of colorectal cancer undergoing endoscopic ultrasound-guided fine needle aspiration between 2000 and 2013 were included in this study. INTERVENTIONS:The study intervention was endoscopic ultrasound-guided fine needle aspiration. MAIN OUTCOME MEASURES:Endoscopic ultrasound-guided fine needle aspiration performance characteristics and outcome (malignant or benign) were analyzed. The gold standard was cytologic results if malignancy or follow-up if benignity. RESULTS:A total of 58 patients were included (32 men; mean age, 64.2 ± 10.0 years [range, 44–88 years]). The location of the initial neoplasm was the rectum for 42 patients and the colon for 16 patients. Endoscopic ultrasound findings included a mass in the anastomosis (n = 8), perirectal fat (n = 23), lymph nodes (n = 20), or asymmetric thickness of the rectal wall (n = 6). Cytology showed malignancy in 38 patients (67%), benign features in 17 (30%), and was not evaluable in 2. Mean follow-up to confirm a benign outcome was 51.3 ± 30.3 months (range, 5.2–180.0 months). Final outcome was recurrence in 40 patients (69%) and benignity in 18 patients (31%). Performance characteristics of endoscopic ultrasound-guided fine needle aspiration were sensitivity (97%), specificity (100%), positive predictive value (100%), negative predictive value (94%), and accuracy (98%). In the intention to diagnose analysis, the corresponding values were 95%, 100%, 100%, 90%, and 96%. LIMITATIONS:This was a retrospective series with a limited number of patients. CONCLUSIONS:Endoscopic ultrasound-guided fine needle aspiration is a highly accurate tool for the cytologic diagnosis of perirectal recurrence in patients with previous colorectal cancer.