Ann Coloproctol.
2019 Feb;35(1):24-29. 10.3393/ac.2018.07.31.
Variation in the Height of Rectal Cancers According to the Diagnostic Modalities
- Affiliations
-
- 1Department of Colon and Rectal Surgery, Chonnam National University Hwasun Hospital, Hwasun, Korea.
- 2Department of Colon and Rectal Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ipark@amc.seoul.kr
- 3Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 4Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 5Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- KMID: 2446790
- DOI: http://doi.org/10.3393/ac.2018.07.31
Abstract
- PURPOSE
Although the height of a rectal tumor above the anal verge (tumor height) partly determines the treatment strategy, no practical standard exists for reporting this. We aimed to demonstrate the differences in tumor height according to the diagnostic modality used for its measurement.
METHODS
We identified 100 patients with rectal cancers located within 15 cm of the anal verge who had recorded tumor heights measured by using magnetic resonance imaging (MRI), colonoscopy, and digital rectal examination (DRE). Tumor height measured by using MRI was compared with those measured by using DRE and colonoscopy to assess reporting inconsistencies. Factors associated with differences in tumor height among the modalities were also evaluated.
RESULTS
The mean tumor heights were 77.8 ± 3.3, 52.9 ± 2.3, and 68.9 ± 3.1 mm when measured by using MRI, DRE, and colonoscopy, respectively (P < 0.001). Agreement among the 3 modalities in terms of tumor sublocation within the rectum was found in only 39% of the patients. In the univariate and the multivariate analyses, clinical stage showed a possible association with concordance among modalities, but age, sex, and luminal location of the tumor were not associated with differences among modalities.
CONCLUSION
The heights of rectal cancer differed according to the diagnostic modality. Tumor height has implications for rectal cancer's surgical planning and for interpreting comparative studies. Hence, a consensus is needed for measuring and reporting tumor height.
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