講演情報
[JKS1-1]The Role of MRI in the Preoperative Diagnosis for Rectal Cancer
Kazushige Kawai, Daisuke Nakano, Misato Takao, Hiroki Kato (Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital)
Local recurrence after rectal cancer surgery can occur in two distinct forms: central pelvic recurrence and lateral pelvic recurrence, and even after chemoradiotherapy (CRT), residual metastatic lateral lymph nodes may result in lateral pelvic recurrence.
We conducted a nationwide prospective study to determine the optimal indication for the lateral lymph node dissection (LLND) by preoperative MRI, which included 337 rectal cancer patients who underwent TME plus LLND. We developed the criteria using the initial 212 patients, and validated them using the remaining 125 patients. Through this study, we could establish criteria for LLND which could be applied to all patients without preoperative treatment, with neoaduvant chemotherapy (NAC), and with CRT, as follows;
1. Small nodes; <3.5 mm in long axis
2. Rod-shaped nodes; short/long ratio <0.5
3. Oval nodes of intermediate size; <7 mm in long axis and short/long ratio <0.7
I'll also show the result of other sub-analyses of the study, including the development of two AIs for the determination of lateral lymph node metastasis.
In addition, I'll overview of the published studies investigating the diagnostic accuracy of MRI for lateral lymph node metastasis.
We conducted a nationwide prospective study to determine the optimal indication for the lateral lymph node dissection (LLND) by preoperative MRI, which included 337 rectal cancer patients who underwent TME plus LLND. We developed the criteria using the initial 212 patients, and validated them using the remaining 125 patients. Through this study, we could establish criteria for LLND which could be applied to all patients without preoperative treatment, with neoaduvant chemotherapy (NAC), and with CRT, as follows;
1. Small nodes; <3.5 mm in long axis
2. Rod-shaped nodes; short/long ratio <0.5
3. Oval nodes of intermediate size; <7 mm in long axis and short/long ratio <0.7
I'll also show the result of other sub-analyses of the study, including the development of two AIs for the determination of lateral lymph node metastasis.
In addition, I'll overview of the published studies investigating the diagnostic accuracy of MRI for lateral lymph node metastasis.