The prediction of the prognosis for rectal carcinoma down-staged by pre-operative radiotherapy by transrectal ultrasonography.
BACKGROUND
We attempted to determine whether the results of transrectal ultrasonography (TRUS) could provide any prognostic information about patients with rectal carcinoma treated with pre-operative radiotherapy (RT).


METHODS
Ninety-eight patients with rectal carcinoma were treated with pre-operative RT and radical surgery. We categorized the TRUS results with respect to TNM classification before the RT (Pre-RT staging), those after the RT (Post-RT staging), and the results of the pathological examination (Post-OP staging). We analysed the associations among these three stagings, and the survival time of the patients.


RESULTS
The prevalence of under T2-stage (TNM classification) in the pre-RT staging was significantly lower than that in both the Post-RT and Post-OP staging. The number of tumours diagnosed as T4 stage in both the Post-RT and Post-OP staging was significantly lower than that before irradiation. The survival periods of the patients with tumours remaining as T4 after radiation were significantly shorter than those of the patients diagnosed as having T4 tumours at the Pre-RT staging (Pre-RT versus Post-RT, p = 0.019; Pre-RT versus Post-OP, p = 0.030). These results suggested that radio-insensitive residual cells might associate with the poor prognosis.


CONCLUSIONS
We could predict the possible prognosis in rectal carcinoma patients treated with pre-operative radiotherapy before operation by TRUS.
Yanagi
H
H
Second Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
Kusunoki
M
M
Yamamura
T
T
D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D014463:Ultrasonography