[Value of preoperative study methods in midrectal cancer. Microscopy versus macroscopy].

A retrospective analysis was made of data pre-operatively obtained from 110 patients who had undergone curative, palliative or exploratory surgery for midrectal carcinoma, between 1972 and 1983. Macroscopic tumour findings obtained from rectoscopy, in that context, were found to provide a clue to loco-regional spread (p = between 0.0001 and 0.0162). On the other hand, no information as to loco-regional spread proved to be recordable by histological typing of mid-rectum carcinomas, but for tubulo-papillary carcinoma (p = 0.0153). Grading could provide a clue as to possible lymph node involvement (p = 0.0205). A clearly differentiated prognosis could be usually made by macroscopic tumour appearance (p = 0.0001 to 0.0657). Histological typing was of no value for prognostication (p larger than 0.337), while the value of grading proved to be extremely low (p = 0.1819). Incidence of locally delimited recurrences could not be safely forecast at all, neither by macroscopic assessment (p larger than 0.119) nor by microscopy (p larger than 0.161). The information obtainable from macroscopic findings on both present phase and prognosis was generally greater than that recorded from histological processing of biopsy material (p = 0.0470) and should, therefore, by no means be neglected in pre-operative reconnaissance.