What is the accuracy rate of preoperative T and N staging in rectal cancer?

• Main Author: Gidey, Diana
• Format: Others
• Language: English
• Published: Örebro universitet, Institutionen för medicinska vetenskaper 2021
• Subjects: Medical and Health Sciences; Medicin och hälsovetenskap
• Online Access: http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-93294

Introduction Colorectal cancer is the third most common cause of cancer deaths in the western world. Each year, approximately 2200 people are being diagnosed with rectal cancer in Sweden.The identification of prognostic factors has a high impact preoperatively since prognostic information obtains opportunities for preoperative oncological treatment, which may lead to higher survival rates. Aim Is to evaluate the accuracy of preoperative staging in rectal cancer, and to estimate the occurrence of over- and understaging in order to observe patterns, intending to improve future assessments. Methods Retrospective data has been collected from the Swedish Colorectal Cancer Register and the medical records. This study included all patients operated on with curative intent 2016-2018 in Region Örebro county. Results In total, 115 were included in the present study. 75 patients had received preoperative treatment while 40 had not. In accordance with the hypothesis, inaccuracy in preoperative staging has been discovered, the kappa coefficient in tumor (T) staging was 0.68 and for node (N) staging 0.81. Furthermore, the results showed an occurrence of both over- and understaging tumors and nodes. Conclusions All patients included were completely staged. The kappa coefficient in T staging indicated substantial agreement, meanwhile N staging had a higher kappa coefficient, suggesting almost perfect agreement. Educational efforts could potentially increase the level of accuracy. For this to succeed, education of radiologists and optimization of the use of the radiological protocol is necessary.