Staging of rectosigmoid neoplasia with colonoscopic endoluminal ultrasonography

Background: The accurate staging of colorectal neoplasia may aid the strati fication of patients for adjuvant treatment. At present the mural extent of neoplasia proximal to the mid rectum is difficult to determine. Prediction of mural invasion could help identify patients suitable for radical resect ion, minimal access surgery or endoscopic treatment. Colonoscopic endolumin al ultrasonography (EUS) was used in a prospective study to determine the s tage of rectosigmoid neoplasia in 121 patients. Methods: Mural tumour (T) stage was designated by EUS as uT(0/1)-uT(4) in 1 21 patients. Nodal (N) staging was performed in 39 cases. EUS staging was c ompared with histological stage (pT and pN) in 93 patients who underwent re section. Results: Mural staging of disease using colonoscopic EUS show ed good corre lation with histopathological stage (kappa=0.85 (95 per cent confidence int erval 0.76-0.95)). Overall pT and pN stage accuracy of EUS was 92 and 65 pe r cent respectively. Conclusion: EUS accurately assessed tumour stage although node staging rema ined suboptimal. Colonoscopic EUS may aid the selection of treatment in pat ients with rectosigmoid neoplasia.