Learning objectives
To better understand current conservative surgical techniques used for resection of malignant rectal lesions with curative intent.
Learnthe anatomy of both rectal MRI and endoscopic ultrasound (EUS) which is required for appropriate patient selection prior to minimally invasive surgery.
Understand what the surgeon wants to know,
with reference to the specific surgical techniques and suggestions for structured reporting.
Background
Colorectal cancer is currently the third most common cancer and the fourth most common cause of cancer-related deaths (1).
There are approximately 41,000 new cases of colorectal cancer in the United Kingdom every year (2013-2015).
The National Cancer Institute’s database quotes the five-year relative survival rate for stage I rectal cancer to be 88%,
dropping to 81% for stage IIa disease and 58% for stage IIIc disease.
Trends toward earlier diagnosis due to screening
Bowel screening programmes for colorectal cancer are in place throughout the...
Findings and procedure details
Definition of early rectal cancer
Early rectal cancer is defined as a "rectal cancer with good prognostic features that might be safely removed preserving the rectum,
and that will have a very limited risk of relapse after local excision." (6).
This generally indicates T1 tumours with no local nodes (N0) and a low risk of lymph node metastases.
The risk of lymph node involvement increases with the presence of lymphovascular invasion and poor tumour differentiation.
Imaging of early rectal cancer:
MRI and endorectal ultrasound (ERUS)...
Conclusion
This poster is a brief overview of the topical and complex discussion surrounding the appropriate management and follow-up of early rectal cancer.
A fundamentalunderstanding of evolving conservative surgical techniques for earlyrectal cancer underpins the role of the radiologist in management pathway planning,
both in the multidisciplinary team and in accurate reporting.
The management of early rectal cancer should always be based on a multidisciplinary approach,
aiming to increase the rate of organ-preserving procedures without jeopardising survival (6).
Personal information
Contact details:
Dr.Kelsey Watt
Radiology Registrar.
Department of Radiology,
Derriford Hospital.
University Hospitals PlymouthNHS Trust.
Derriford Road,
Plymouth UK.
PL6 8DH.
Email:
[email protected]
Dr.
Thomas Tolley
Surgical Trainee.
Department of General Surgery,
The Royal Cornwall Hospital.
Treliske,
Truro,
Cornwall,
UK.
TR1 3LQ.
Dr.Dushyant Shetty
Consultant Radiologist.
Department of Radiology,The Royal Cornwall Hospital.
Treliske,
Truro,
Cornwall,
UK.
TR1 3LQ.
Dr.
Madeline Strugnell
Consultant Radiologist.
Department of Radiology,The Royal Cornwall Hospital.
Treliske,
Truro,
Cornwall,
UK.
TR1 3LQ.
References
World Cancer Research Fund,
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(2007).Food,
nutrition,
physical activity,
and the prevention of cancer: a global perspective(Vol.
1).
Amer Inst for Cancer Research.
UK Screening Committee (2014).
Bowel cancer screening across the UK.UK screening portalPublic Health England. http://www.screening.nhs.uk/ [Accessed January 2018]
Arnold M,
Sierra MS,
Laversanne M et al (2017).
Global patterns and trends in colorectal cancer incidence and mortality.
Gut,
66(4),
683-691
Amin MB,
Edge SB,
Greene FL,
et al,
eds.
AJCC Cancer Staging Manual.
8th ed.
New York:...