The current status of nodal staging in rectal cancer
File(s)
Published version
Author(s)
Lord, Amy
D'Souza, Nigel
Shaw, Annabel
Day, Nigel
Brown, Gina
Type
Journal Article
Abstract
Purpose of Review
To review current practice in MRI-based nodal staging in rectal cancer and assess the associated evidence.
Recent Findings
Nodal staging is less accurate than other MRI-detected prognostic markers such as circumferential resection margin status, extramural venous invasion and T stage. Previous research has focused on matching MRI and pathology findings but crucially N stage has never been shown to have prognostic importance on MRI. Recent pathological evidence suggests that tumour deposits may be more important than nodal status and these can be clearly distinguished from nodal metastases on MRI.
Summary
Nodal staging on MRI is prognostically inaccurate. MRI staging should move away from TNM to focus on those radiological markers which can be proved to have prognostic accuracy. Tumour deposits should be reported separately to lymph node metastases on both histopathology and imaging. Research is underway confirming their prognostic importance on MRI.
To review current practice in MRI-based nodal staging in rectal cancer and assess the associated evidence.
Recent Findings
Nodal staging is less accurate than other MRI-detected prognostic markers such as circumferential resection margin status, extramural venous invasion and T stage. Previous research has focused on matching MRI and pathology findings but crucially N stage has never been shown to have prognostic importance on MRI. Recent pathological evidence suggests that tumour deposits may be more important than nodal status and these can be clearly distinguished from nodal metastases on MRI.
Summary
Nodal staging on MRI is prognostically inaccurate. MRI staging should move away from TNM to focus on those radiological markers which can be proved to have prognostic accuracy. Tumour deposits should be reported separately to lymph node metastases on both histopathology and imaging. Research is underway confirming their prognostic importance on MRI.
Date Issued
2019-10-01
Date Acceptance
2019-08-01
Citation
Current Colorectal Cancer Reports, 2019, 15 (5), pp.143-148
ISSN
1556-3804
Publisher
Springer (part of Springer Nature)
Start Page
143
End Page
148
Journal / Book Title
Current Colorectal Cancer Reports
Volume
15
Issue
5
Copyright Statement
© The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000492408500001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Oncology
Rectal cancer
MRI
Staging
Lymph nodes
Tumour deposits
Prognosis
PERICOLONIC TUMOR DEPOSITS
DISEASE-FREE SURVIVAL
COLORECTAL-CANCER
PROGNOSTIC-SIGNIFICANCE
LOCAL RECURRENCE
LYMPH-NODES
METASTASES
ACCURACY
INVASION
Publication Status
Published
Date Publish Online
2019-08-28