The clinical staging of rectal cancer

摘要: The ability of rectal digital examination to recognize significant stages local extent and lymph node involvement in adenocarcinoma the lower two-thirds rectum was investigated. Seventy patients with a palpable cancer were examined by 2 or 3 out panel 10 clinicians including consultants 8 registrars. A defined protocol used results recorded on proforma. Clinical findings compared pathological resected specimen final surgical assessment when growth not removed. In 38 computed tomography primary performed also findings. Four groups cases different degrees spread recognized 67–83 per cent 44–78 Computed correctly identified growths extensive 89 cases, but no more reliable than other involvement. Based results, clinical staging system is proposed, comprising four as follows—stage 1: confined rectum; stage 2: slight extrarectal spread; 3: moderate 4: organs unresectability. Two are proposed: namely, negative positive. Each corresponds survival recurrence rates after surgery. Combined factors, such level size tumour, histological grade general state patient, may facilitate choice treatment. It might extend use major sphincter-saving procedures, indentify many suitable for treatment define those considerable risk where combined surgery radiotherapy be considered.