Modern therapy in colon and rectal cancer is a multdisciplinary approach, where high quality surgery is still of primary importance. Several new aspects have evolved during the past years, of which screening colonoscopy, standardization of surgical procedures, quality control, the further development of stage dependend multimodal therapies and fast track rehabilitation have significanly contributed to improving patient outcome. Adjuvant chemotherapy in UICC stage Ⅲ colon cancer patients and neoadjuvant radiochemotherapy in T3/4 and/or lymph node positive rectal cancer patients are well established. The preoperative assessment of the circumferential resection margin in rectal cancer is emerging as an important parameter for the indication to neoadjuvant therapy. In a selected group of patients with early T1 colorectal cancer endoscopic polypectomy might be appropriate while laparoscopic surgery for colon cancer is at the edge of becoming an equivalent option to open surgery. Molecular and genetic factors, such as thymidylate synthase, microsatellite instability or mutations of the K-ras protein, might help to better select patients for adjuvant chemotherapy or antibody based antitumor therapy in the future.

Modern therapy in colon and rectal cancer is a multdisciplinary approach, where high quality surgery is still of primary importance. Several new aspects have evolved during the past years, of which screening colonoscopy, standardization of surgical procedures, quality control, the further development of stage dependend multimodal therapies and fast track rehabilitation have significanly contributed to improving patient outcome. Adjuvant chemotherapy in UICC stage Ⅲ colon cancer patients and neoadjuvant radiochemotherapy in T3/4 and/or lymph node positive rectal cancer patients are well established. The preoperative assessment of the circumferential resection margin in rectal cancer is emerging as an important parameter for the indication to neoadjuvant therapy. In a selected group of patients with early T1 colorectal cancer endoscopic polypectomy might be appropriate while laparoscopic surgery for colon cancer is at the edge of becoming an equivalent option to open surgery. Molecular and genetic factors, such as thymidylate synthase, microsatellite instability or mutations of the K-ras protein, might help to better select patients for adjuvant chemotherapy or antibody based antitumor therapy in the future.

INTRODUCTIONWe evaluated the accuracy of endorectal magnetic resonance imaging (MRI) in the staging of prostate cancer.

MATERIALS AND METHODSWe retrospectively reviewed 32 patients who underwent endorectal MR prostate prior to radical prostatectomy. The tumour stage based on MR imaging was compared with the pathologic stage. The sensitivity and specificity of endorectal MR prostate in the evaluation of extracapsular extension (ECE) of the tumour were then determined.

RESULTSMR correctly diagnosed 17 cases of organ-confined prostate carcinoma and 2 cases of locally advanced disease. In the evaluation of ECE, endorectal MR achieved a high specificity of 94.4%, low sensitivity of 14.3% and moderate accuracy of 59.4%.

CONCLUSIONEndorectal MR prostate has high specificity for the detection of ECE. It is useful in the local staging of prostate cancer in patients with intermediate risk as this helps to ensure that few patients will be deprived of potentially curative surgery.

Adult ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Medical Audit ; Middle Aged ; Neoplasm Staging ; methods ; Prostatectomy ; Prostatic Neoplasms ; pathology ; surgery ; Rectum ; Retrospective Studies ; Sensitivity and Specificity