Reliability and Value of Diagnostic Lymphography in Carcinoma of the Sigmoid, Rectum and Anus.

Abstract

From 1963 to 1973, 253 patients with cancer of the sigmoid, rectum and anus underwent diagnostic lymphography at the Istituto Nazionale Tumori of Milan. In 218 patients lymphography was performed as part of the initial diagnostic work-up, while in 35 it was done during the follow up period, after surgery. The accuracy of radio-histological correlation was 95 %. This confirms the reliability of diagnostic lymphography and its clinical usefulness. In view of these results, this diagnostic tool is essential in the initial evaluation in patients with carcinoma of the anus, because lymphography was superior (28 %) to the clinical inspection (6 %) in the evaluation of the inguino-iliac lymph nodes. Lymphography is also useful in rectal cancer since it permits, in case of nodal metastases, selection of a group of patients in whom the therapeutic program should be revised. The exam is useless in cancer of the sigmoid. In the small group of patients who had lymphography in the follow up period, this technique was the only to show, in symptomatic patients, the presence of pelvic and/or para-aortic nodal metastases. Lymphography is also useful in these patients for the evaluation of the results of the radio/chemotherapy on involved nodes.