Efficacy of endoscopic ultrasound in the evaluation of post-radiotherapy rectal tumor

Authors

Keywords:

neoplasms, predictive value of tests, rectum, sensitivity and specificity.

Abstract

Introduction: Local restaging of rectal tumor to assess the degree of rectal wall invasion determines the extent of surgical intervention. Endoscopic ultrasound is an accurate technique in initial staging, but has limitations in post-radiation therapy evaluation.
Objective: To determine the diagnostic efficacy of endoscopic ultrasound in the evaluation of post-radiotherapy rectal tumor.
Methods: Observational, descriptive, cross-sectional, case series study of 54 patients with irradiated rectal tumor re-evaluated by endoscopic ultrasound at the National Center for Minimal Access Surgery between September 2018 and December 2022. To determine the efficacy of endoscopic ultrasound, the following were calculated: sensitivity, specificity, positive and negative predictive value, likelihood ratios, Youden index and diagnostic agreement according to kappa index. The histological study of the surgical specimen was the reference standard.
Results: The overall concordance of the endoscopic ultrasound was 79.6%, the kappa index was weak (k= 0.1951; p= 0.05). It showed good sensitivity (97.62%), however, specificity, negative predictive value and positive likelihood ratio were low. Of the patients, 48.1% were overstaged. The validity index was good (79.63%) and the test performance showed a Youden index of 0.14.
Conclusions: The efficacy of endoscopic ultrasound in the evaluation of post-radiotherapy rectal tumor, has limitations due to its low specificity; it fails to discriminate between fibrosis and residual malignant lesion.

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Author Biographies

Misdrialis Martínez Romero, Hospital Militar Dr."Carlos J Finlay"

Especialista de II grado en Gastroenterología.Master en Urgencias Mèdicas y Cirugía de Minimo Acceso.Profesor auxiliar e investigador auxiliar.

Norberto Alfonso Contino, Centro Nacional de Cirugía de Mínimo Acceso. La Habana, Cuba.

Especialista de II grado en Gastroenterología. Doctor en Ciencias. Profesor e investigador auxiliar

Raúl Antonio Brizuela Quintanilla, Hospital Militar Dr. " Luis Díaz Soto" . La Habana, Cuba.

Especialista de II grado en Gastroenterología. Doctor en Ciencias. Profesor e investigador titular

Javier Ernesto Barreras González, Centro Nacional de Cirugía de Mínimo Acceso. La Habana, Cuba.

Especialista de II grado en Cirugía. Doctor en Ciencias. Profesor e investigador titular

Jorge Luis García-Menocal Hernández, Centro Nacional de Cirugía de Mínimo Acceso. La Habana, Cuba.

Especialista de II grado en Gastroenterología. Profesor e investigador auxiliar

Pablo Miguel Raventós Vaquer, Universidad de Ciencias Médicas de las Fuerzas Armadas Revolucionarias. La Habana, Cuba

Especialista en Medicina Interna. Diplomado en Terapia Intensiva. Profesor asistente. Master en Urgencias Médicas.

Ignacio Hung Martínez, Centro de Investigaciones Médico- Quirúrgicas

Residente de Medicina Interna

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Published

2023-06-20

How to Cite

1.
Martínez Romero M, Alfonso Contino N, Brizuela Quintanilla RA, Barreras González JE, García-Menocal Hernández JL, Raventós Vaquer PM, et al. Efficacy of endoscopic ultrasound in the evaluation of post-radiotherapy rectal tumor. Rev Cubana Med Milit [Internet]. 2023 Jun. 20 [cited 2025 Apr. 3];52(3):e02302873. Available from: https://revmedmilitar.sld.cu/index.php/mil/article/view/2873

Issue

Vol. 52 No. 3 (2023): July - september

Section

Research Article

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