2021, Number 1
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Acta Med 2021; 19 (1)
Determination of morphological parameters by magnetic resonance of rectal tumors to establish a rectometry scoring system (R.E.C.T.A.L. score) that allows us to estimate the degree of surgical complexity
Argüello RV, Gómez PMG
Language: Spanish
References: 9
Page: 21-24
PDF size: 170.71 Kb.
ABSTRACT
Objective: To describe the morphological characteristics of rectal tumors by magnetic resonance imaging (MRI) in order to establish a rectometry scoring system (R.E.C.T.A.L. score) that enables the surgical complexity grading estimation.
Material and methods: An observational, descriptive, cross-sectional, ambispective study was carried out selecting a sample of patients that came to the
Hospital Ángeles Pedregal from March 2017 to December 2019. Including all patients diagnosed with rectal carcinoma who would have undergone MRI, the instrument referred to as R.E.C.T.A.L. score (R.E.C.T.A.L. RM HAP/2019) was applied to patients to measure qualitative and quantitative variables, thus determine surgical risk.
Results: Of the 48 patients that entered the study, 16 (33%) of them had a low surgical complexity, 16 (33%) moderate and 16 (33%) high.
Conclusions: The proposed punctuation for surgical complexity has not been accepted. In our population that includes patients with rectal tumors assessed by MRI, specific modifications were made for this type of injury and we found that provides specific details that can be used by surgeons to perform an adequate surgical approach and to complement it with adjunctive therapy.
REFERENCES
Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015; 136 (5): E359-E386.
American Cancer Society. Cancer facts and figures 2018. [Accessed May 1, 2018] Available in: https://www.cancer.org/research/cancer-facts-statistics/all-cancer-facts-figures/cancer-facts-figures-2018.html
Bailey CE, Hu CY, You YN, Bednarski BK, Rodriguez-Bigas MA, Skibber JM et al. Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975-2010. JAMA Surg. 2015; 150 (1): 17-22.
Nagtegaal I, Gaspar C, Marijnen C, Van De Velde C, Fodde R, Van Krieken H. Morphological changes in tumour type after radiotherapy are accompanied by changes in gene expression profile but not in clinical behaviour. J Pathol. 2004; 204 (2): 183-192.
Krook JE, Moertel CG, Gunderson LL, Wieand HS, Collins RT, Beart RW et al. Effective surgical adjuvant therapy for high-risk rectal carcinoma. N Engl J Med. 1991; 324 (11): 709-715.
Gastrointestinal Tumor Study Group. Prolongation of the disease-free interval in surgically treated rectal carcinoma. N Engl J Med. 1985; 312 (23): 1465-1472.
NIH consensus conference. Adjuvant therapy for patients with colon and rectal cancer. JAMA. 1990; 264 (11): 1444-1450.
Sauer R, Becker H, Hohenberger W, Rödel C, Wittekind C, Fietkau R et al. Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med. 2004; 351 (17): 1731-1740.
National Comprehensive Cancer Network. NCCN guidelines: version 2.2017-rectal cancer. September 10, 2017. [Accessed May 1, 2018] Available in: https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf.