Impact of surgical staging for aggressive histology rectal cancers: a retrospective review. Issue 3 (30th December 2020)

• Record Type: Journal Article
• Authors: Kazi, Mufaddal; Nekkanti, Sri Siddhartha; Rohila, Jitender; Patel, Swapnil; Sukumar, Vivek; Desouza, Ashwin; Saklani, Avanish
• Is Part Of: ANZ journal of surgery. Volume 91:Issue 3(2021)
• Page Start: E119
• Page End: E122
• Publication Date: 2020-12-30
• Subjects: cytoreduction -- rectal cancer; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.16496
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: 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. Abstract : Surgical staging for aggressive histology (poorly differentiated and signet ring) rectal cancers led to upstaging of non‐metastatic advanced rectal cancers in nearly 30% of patients. There was a change in treatment protocol and intent in 20.5% and 15.4%, respectively, in our retrospective study of 117 patients.