Poster Author of 1 e-Poster
SE-043 - Does Surgical acceptance of radiology accuracy limit the implementation of organ preservation in early rectal cancer ?
Author of 1 Presentation
SE-043 - Does Surgical acceptance of radiology accuracy limit the implementation of organ preservation in early rectal cancer ?
Abstract
Purpose
The national uptake of organ preservation in early rectal cancer in the UK is 17%. Local preservation rates, and potential factors influencing this were reviewed locally for all radiologically staged T1/T2 cancers over a 7 year period.
Material and methods
The medical records of 170 consecutive patients from 2012-2018 with MRI and/or endorectal US staged T1 or T2 rectal cancers were reviewed. Where organ preservation was not performed, the reasons were documented from clinical correspondence. Patients with subsequent benign post-op pathology were included.
Results
Twenty four patients were excluded. The reasons for exclusion were: location higher than 12cm above anal verge (8), unfit/unsuitable for surgery (1), mucinous or adverse histology (3), sphincter involvement (1), MRI node positive (9) or incomplete endoscopic mucosal resection (EMR) or transanal endoscopic microsurgery (TEMS) (2). 82.2% (120/146) patients had organ preservation. Patient choice or clinician preference accounted for 13.0%(19/146). In 4.8% of patients the reason for surgery was not specified. 92.5% of T1s and 80% of T2s had organ preservation. 45.5% (20/44) of all T1s were diagnosed in 2018 following an in-house training programme of 100 validated T1/T2 cases, with 54.5% (24/44) diagnosed over the preceding 6 years.
Conclusion
Surgical acceptance of radiology staging is consistent, with organ preservation directed by the MRI/Endoscopic US staging. An increase in organ preservation rates followed improved case finding and increased yield of T1/T2 on MRI. This post dates the introduction of internal training and validation of early rectal cancer staging, suggesting radiology training, not surgical acceptance, is the limiting step.
Presenter of 1 Presentation
SE-043 - Does Surgical acceptance of radiology accuracy limit the implementation of organ preservation in early rectal cancer ?
Abstract
Purpose
The national uptake of organ preservation in early rectal cancer in the UK is 17%. Local preservation rates, and potential factors influencing this were reviewed locally for all radiologically staged T1/T2 cancers over a 7 year period.
Material and methods
The medical records of 170 consecutive patients from 2012-2018 with MRI and/or endorectal US staged T1 or T2 rectal cancers were reviewed. Where organ preservation was not performed, the reasons were documented from clinical correspondence. Patients with subsequent benign post-op pathology were included.
Results
Twenty four patients were excluded. The reasons for exclusion were: location higher than 12cm above anal verge (8), unfit/unsuitable for surgery (1), mucinous or adverse histology (3), sphincter involvement (1), MRI node positive (9) or incomplete endoscopic mucosal resection (EMR) or transanal endoscopic microsurgery (TEMS) (2). 82.2% (120/146) patients had organ preservation. Patient choice or clinician preference accounted for 13.0%(19/146). In 4.8% of patients the reason for surgery was not specified. 92.5% of T1s and 80% of T2s had organ preservation. 45.5% (20/44) of all T1s were diagnosed in 2018 following an in-house training programme of 100 validated T1/T2 cases, with 54.5% (24/44) diagnosed over the preceding 6 years.
Conclusion
Surgical acceptance of radiology staging is consistent, with organ preservation directed by the MRI/Endoscopic US staging. An increase in organ preservation rates followed improved case finding and increased yield of T1/T2 on MRI. This post dates the introduction of internal training and validation of early rectal cancer staging, suggesting radiology training, not surgical acceptance, is the limiting step.