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Impact of surgical staging for aggressive histology rectal cancers: a retrospective review
Author(s) -
Kazi Mufaddal,
Nekkanti Sri Siddhartha,
Rohila Jitender,
Patel Swapnil,
Sukumar Vivek,
Desouza Ashwin,
Saklani Avanish
Publication year - 2021
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.16496
Subject(s) - medicine , occult , histology , metastasis , retrospective cohort study , colorectal cancer , incidence (geometry) , cancer , adenocarcinoma , surgery , radiology , pathology , physics , alternative medicine , optics
Background Poorly differentiated adenocarcinomas and signet ring adenocarcinomas are aggressive histological subtypes of rectal cancer with a high incidence of occult peritoneal metastasis. Methods This was a retrospective review of aggressive histology of rectal cancer patients who underwent pre‐treatment surgical staging as part of ovarian transposition or ostomy creation for diversion at a single tertiary cancer centre between January 2014 and December 2019. Results A total of 117 patients underwent surgical staging and were deemed non‐metastatic on imaging. Surgical staging led to the detection of metastasis in 29.9% of patients. This led to modification in treatment protocol in 20.5% and change in intent of therapy in 15.4%. The majority (80%) was found to have peritoneal disease with peritoneal carcinomatosis index <17. Only T4 disease predicted the presence of metastasis on surgical staging with an odds ratio of 2.69 ( P = 0.035). Conclusions A significant proportion of patients with aggressive histology rectal cancers are upstaged after surgical staging. Further investigation of this tool for staging is warranted.