Preoperative Radiologic (CT and MRI) Staging of Rectal Cancer as seen from TASH: A Three- year Descriptive Cross Sectional Study, Addis Ababa, Ethiopia.

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Addis Abeba University


Background: Rectal cancer is one of the most common cancers worldwide and its incidence is reported to be increasing in resource-limited countries, probably due to the acquisition of a western lifestyle. The preoperative radiological stage also has been suggested to be correlated with the prognosis of colon cancer and helps in guiding specific treatments. However, information regarding imaging of rectal cancer in Ethiopia is limited. The main aim of the study was to assess the preoperative imaging staging of Rectal cancer and correlating with pathologic stage in TASH. Method: Institutional based descriptive cross sectional study conducted at TASH Addis Ababa, Ethiopia for the duration of 2018-2021. The Study was conducted among histologically proven rectal cancer patients at TASH and that have complete staging work up before treatment initiation during the study period. Data was collected from the operation room logbook, Oncology center cancer registry logbook, patient medical records and PACS for the images. The data was checked for clarity and completeness. Computerized data analysis was conducted by using SPSS version 25 software. Results: A total of 247 rectal cancer patients were enrolled in the study among which males were 123 and females 124 with median age of patients at presentation of 44 years. The majority of patients (99.6%) presented late with advanced stages (stage II-IV). Lymph node and distant metastasis at the time of diagnosis was recorded in 79.3% and 21% of cases, respectively. Liver was the most common site of distant metastasis. The low rectum was the most frequent anatomical site involved and all were adenocarcinoma (100%) by histology. Mucinous and signet ring carcinomas accounted for 16 (6.5%) and 18 (7.3%) patients, respectively. Overall accuracy, sensitivity and specificity of MRI was better than MDCT in local staging of rectal cancer. Conclusions: Rectal cancer is not uncommon in our country and shows a trend towards a relative young age at diagnosis and the majority of patients present late with advanced stage. There is a need for screening of high-risk populations, early diagnosis and appropriate staging work up for a patient, which guides treatment options. Promoting the use of MRI for local staging than MDCT that has high accuracy, sensitivity and specificity.



CT , MRI,Rectal cancer ,Preoperative radiology