Aims and objectives
Recent studies suggest there is little clinical benefit in routine computed tomography (CT) thorax for staging colorectal cancer (CRC).
The aim of this study is to evaluate the clinical value of CT thorax by focusing on patients who had a diagnosis of indeterminate or metastatic lung lesions on staging CT.
Methods and materials
This is a case control study with planned data collection of patients diagnosed with CRC at our institution over a five-year period (2006-2011).
All patients who undergo colorectal surgery in our hospital are prospectively registered,
and histopathological characteristics; outcome; and follow-up.
Since January 2007,
routine preoperative staging CT of thorax,
abdomen and pelvis (TAP) for patients with CRC has been performed as part of our regional guidelines.
All recorded variables were analysed to determine factors associated with the presence of lung metastasis...
383 patients were identified.[Figure 1] The mean age was 66.7±12.2 years.
235 were male (61.4%).
206 (53.8%) colonic and 177 (46.2%) rectal tumours were involved.
Evidence of distant metastatic disease was evident in 71 patients (18.5%) based on staging CT-TAP.
Staging CT-thorax revealed pulmonary metastases in 25 patients (6.5%) and indeterminate lesions in 33 patients (9%).
60% of pulmonary metastases were not evident on pre-operative chest x-ray.
All patients who had evidence of lung metastases had node positive disease (p=0.03).
No other clinical or pathological...
Pulmonary metastasis are relatively rare in CRC and staging CT thorax should be reserved for ‘at risk’ cohorts.
Once the liver has been confirmed disease free,
pathological confirmation of high-risk tumors (node positive,
T3/T4) is an indication for formal thoracic staging.
Indeterminate pulmonary lesions showed a 20% malignant potential.
Evaluation of the introduction of a standardised protocol for the staging and follow-up of colorectal cancer on resection rates for liver metastases.
Ann R Coll Surg Engl. Apr 2010;92:225-230.
RituaM 0 0 2011-10-10T12:29:00Z 2011-10-10T12:29:00Z 1 29 171 1 1 199 14.0 Normal 0 false false false EN-GB JA X-NONE Christoffersen MM,
[The diagnostic value of indeterminate lung lesions on staging chest computed tomographies in patients with colorectal cancer].