Abstracts
1999 Digestive Disease Week

# 2204 RESTAGING OF PRIMARY RECTAL CANCER BY PELVIC CT SCAN AND TRANSRECTAL ULTRASOUND (TRUS)FOLLOWING PREOPERATIVE CHEMORADIOTHERAPY (CRT)
Salvatore Pucciarelli, Federico Cavallari, Clin Chirurgica II, Padova Italy; Matteo Chiesura, Inst di Radiologia, Padova Italy; Decet Giandomenico, Toppan Paola, Clin Chirurgica II, Padova Italy; Anto Andres, Inst di Radiologia, Padova Italy; Riccardo Marchesin, Giuseppe Dodi, Mario Lise, Clin Chirurgica II, Padova Italy

Purpose: To evaluate both the impact and the accuracy of restaging by pelvic CT scan and TRUS following preoperative CRT. Methods: Thirty-one patients (study group)operated on for T3 clinically resectable rectal cancer were restaged by pelvic CT scan and TRUS following preoperative CRT. A control group (26 pts)without preoperative CRT was also staged by pelvic CT scan and TRUS. Each examination was performed blind by two different operators. We recorded both the surgical procedure planned before and that performed after adjuvant therapy. A comparison was made between preoperative (based on the pelvic CT scan and TRUS) and pathologic stage. The c2 test was used for statistical comparison. Significance was set at p£.05. Results:Surgery was locally curative in all patients. No planned surgical procedure was affected by restaging following CRT. The accuracy of pelvic CT scan in the study group and in the control group was 71 and 64% for T stage (p=N.S.), and 81 and 79% for N status (p=N.S.) respectively. The accuracy of TRUS was 45% in the study group and 73% in the control group (p=.0003)for T stage, and 36 and 75% (p=.0002) for N status respectively. While in the control group the accuracy of findings with the two tecniques was similar, in the study group pelvic CT scan was significantly more accurate than TRUS both for T stage (p=.0004) and N status (p=.0005). Conclusion: Restaging of T3 clinically resectable rectal cancer by pelvic CT scan and TRUS following preoperative CRT is not of value because it has no influence on the surgery planned. Moreover, TRUS is not reliable in the restaging of patients who have undergone CRT.

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