title: Endoscopic ultrasound-guided fine needle aspiration is highly accurate for the diagnosis of perirectal recurrence of colorectal cancer.
abstract: BACKGROUND
  Endoscopic ultrasound-guided fine needle aspiration is highly accurate for the diagnosis of malignancies surrounding the gastrointestinal tract. There is a lack of information on the usefulness of this technique in the diagnosis of colorectal cancer recurrence.
  
  
  OBJECTIVE
  The purpose of this work was to investigate the performance characteristics of endoscopic ultrasound-guided fine needle aspiration for the cytologic diagnosis of perirectal recurrence of colorectal cancer.
  
  
  METHODS
  This was a retrospective study on the clinical and radiologic suspicion of perirectal recurrence of colorectal cancer.
  
  
  METHODS
  The study was conducted at 4 tertiary hospitals.
  
  
  METHODS
  Consecutive patients with suspicion of perirectal recurrence of colorectal cancer undergoing endoscopic ultrasound-guided fine needle aspiration between 2000 and 2013 were included in this study.
  
  
  METHODS
  The study intervention was endoscopic ultrasound-guided fine needle aspiration.
  
  
  METHODS
  Endoscopic ultrasound-guided fine needle aspiration performance characteristics and outcome (malignant or benign) were analyzed. The gold standard was cytologic results if malignancy or follow-up if benignity.
  
  
  RESULTS
  A total of 58 patients were included (32 men; mean age, 64.2 ± 10.0 years [range, 44-88 years]). The location of the initial neoplasm was the rectum for 42 patients and the colon for 16 patients. Endoscopic ultrasound findings included a mass in the anastomosis (n = 8), perirectal fat (n = 23), lymph nodes (n = 20), or asymmetric thickness of the rectal wall (n = 6). Cytology showed malignancy in 38 patients (67%), benign features in 17 (30%), and was not evaluable in 2. Mean follow-up to confirm a benign outcome was 51.3 ± 30.3 months (range, 5.2-180.0 months). Final outcome was recurrence in 40 patients (69%) and benignity in 18 patients (31%). Performance characteristics of endoscopic ultrasound-guided fine needle aspiration were sensitivity (97%), specificity (100%), positive predictive value (100%), negative predictive value (94%), and accuracy (98%). In the intention to diagnose analysis, the corresponding values were 95%, 100%, 100%, 90%, and 96%.
  
  
  CONCLUSIONS
  This was a retrospective series with a limited number of patients.
  
  
  CONCLUSIONS
  Endoscopic ultrasound-guided fine needle aspiration is a highly accurate tool for the cytologic diagnosis of perirectal recurrence in patients with previous colorectal cancer.
authors: 1 Endoscopy Unit, Gastroenterology Department, Institut Clínic de Malalties Digestives i Metabòliques, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERehd, University of Barcelona, Barcelona, Spain 2 Endoscopy Unit, Gastroenterology Department, Clínica Universidad de Navarra, Pamplona, Spain 3 Endoscopy Unit, Gastroenterology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
authors: Gloria
authors: G
authors: Fernández-Esparrach
authors: Nadia
authors: N
authors: Alberghina
authors: José Carlos
authors: JC
authors: Subtil
authors: Enrique
authors: E
authors: Vázquez-Sequeiros
authors: Vivian
authors: V
authors: Florio
authors: Francisco
authors: F
authors: Zozaya
authors: Isis
authors: I
authors: Araujo
authors: Angels
authors: A
authors: Ginès
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D002277:Carcinoma / Q000175:diagnosis / Q000473:pathology*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000473:pathology*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000473:pathology*; D010388:Pelvis; D011237:Predictive Value of Tests; D012007:Rectum / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity