Comparison of T and N Staging on Preoperative Magnetic Resonance Imaging and Postoperative Histopathologic Specimens in Rectum Cancer

Aim: Preoperative magnetic resonance imaging (MRI) is one of the most common diagnostic methods in current rectal surgery. In this study, we planned to investigate the concordance between preoperative MRI findings and postoperative histopathological stage in patients with rectal cancer. Conclusion: Although high-resolution MRI is currently one of the first imaging methods used in rectum cancers, additional imaging modalities should be also used there is any doubt about the diagnosis. Method: Fifty-six patients who underwent rectal cancer surgery between September 2014-November 2016 in Adnan Menderes University Faculty of Medicine, Department of Surgery were included in the study. Preoperative and histopathological T and N stages were compared. Results: Fifty-six patients were included in the study. Mean age was 66.05 (38-88) years. Tumor location was classified as lower rectum in 29.8%, mid-rectum in 32.3%, and upper rectum in 37.9% of the patients. While positive lymph nodes were found on MRI in 21 cases, only 15 were confirmed by histopathology. Of the 35 cases reported to be lymph node negative on MRI, 19 were confirmed. The sensitivity was 71.4% for positive lymph nodes and 54.3% for negative lymph nodes. As for T stages, there was a statistically significant association between MRI and pathological staging (p=0.049). Conclusion: Fifty-six patients were included in the study. Mean age was 66.05 (38-88) years. Tumor location was classified as lower rectum in 29.8%, mid-rectum in 32.3%, and upper rectum in 37.9% of the patients. While positive lymph nodes were found on MRI in 21 cases, only 15 were confirmed by histopathology. Of the 35 cases reported to be lymph node negative on MRI, 19 were confirmed. The sensitivity was 71.4% for positive lymph nodes and 54.3% for negative lymph nodes. As for T stages, there was a statistically significant association between MRI and pathological staging (p=0.049).