Laparoscopic ultrasonography not recommended for primary colorectal cancer
Intraoperative laparoscopy and laparoscopic ultrasonography (LUS) offer no clear advantage over preoperative imaging techniques, such as computed tomography and magnetic resonance imaging, in terms of tumour, node and metastasis (TNM) staging and treatment strategy in colorectal cancer, according to a new study.
Therefore, “the routine use of LUS during laparoscopic surgery for primary colorectal cancer cannot be recommended,” said researchers.
The study included 257 adult patients with verified tumours in the colon or rectum and who were randomized either to receive laparoscopic examination alone (control; n=128; mean age 71±9 years) or laparoscopic examination plus LUS (n=129; mean age 69±10 years). Those with distant metastases, mental illnesses and impaired cognitive functions were excluded.
Of the participants, only 54.7 percent were given the correct T stage. Laparoscopy delivered a correct final T category in 53.9 percent (n=62) of the patients, while 21.7 percent (n=25) and 24.3 percent (n=28) were understaged and overstaged, respectively.
Accuracy was similar in the LUS group, where only 66 percent (n=25) were correctly assigned, 24 percent (n=9) were understaged and 11 percent (n=4) were overstaged.
Moreover, nodal status was correct only in 58.1 percent of the patients. Laparoscopy delivered the correct N staging in 62.2 percent (n=79) of the patients. The other 22 percent (n=28) and 15.7 percent (n=20) were understaged and overstaged, respectively.
LUS, on the other hand, assigned the correct N stage to 61 percent (n=22) of the patients, while 25 percent (n=9) and 14 percent (n=5) were understaged and overstaged, respectively.