Preoperative staging of resectability of colon cancer using virtual colonoscopy: correlation with surgical results. Our experience

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Published: Sep 1, 2015
Keywords:
CT colonography, Colorectal cancer, Extracolonic findings, Staging

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Luciano Izzo
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Luca Impara
Department of Radiological Sciences, Sapienza - University of Rome, Rome, Italy
Federico Pugliese
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Monir Al Mansour
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Francesco De Felice
Department of Radiotherapy, Sapienza - University of Rome, Rome, Italy
Carlo De Dominicis
Dipartimento di scienze Ginecologiche Ostetriche e Scienze Urologiche, Sapienza - University of Rome, Rome, Italy
Anna De Santis
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Carlo De Felice
Department of Radiological Sciences, Sapienza - University of Rome, Rome, Italy
Raimondo Gabriele
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Luigi Basso
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Pierfrancesco Di Cello
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Maria Caputo
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy
Paolo Izzo
Department of Surgery, Sapienza - University of Rome, “P. Valdoni”, Rome, Italy

Abstract

PURPOSE: To evaluate the clinical usefulness of preoperative computed tomography colonography (CTC) in locoregional staging in patients with abdominal pain secondary toocclusive colorectal cancer (CRC).


MATERIALS AND METHODS: 80 patients with abdominal pain underwent CTC initially without contrast and after diagnosis with contrast. 47 patients had distal CRC and 33 had proximal CRC. CTimages were analyzed independently by two radiologists, using MPR reconstruction and VR images. Depending on the anatomical depth of wall invasion primary tumor (T) was classified ≤ T2, T3 and T4. The definition of node disease (N) was based on the number of involved regional lymph nodes. Metastases (M) were characterized by the presence and location of distant disease. Pre treatment stage (cT cN) was compared with pathologic stage (pT pN). Accuracy of CTC was also evaluated.


RESULTS: The overall accuracy values for T staging of reviewer 1, reviewer 2 and consensus reading were 91.6%, 86.2% and 92.8% respectively; 92.2%, 79.8% and 92.5% for T2; 88.1%, 85.5%, and 89.7% for T3; and 94.5%, 93.5% and 96.2% for T4. The accuracy values for N staging and M staging were 81,.8%, 94.0% for reviewer 1; 78.2% and 88.1% for reviewer 2; 81.8% and 94.0% for consensus reading, respectively.


CONCLUSION: In our experience CTC is not only useful in the evaluation of the proximal bowel, but can also provide surgeons with accurate information about staging and tumor localization. CTC is recommended for better evaluation of preoperative staging.

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How to Cite
Izzo, Luciano, et al. “Preoperative Staging of Resectability of Colon Cancer Using Virtual Colonoscopy: Correlation With Surgical Results. Our Experience”. Annali Italiani Di Chirurgia, vol. 86, no. 5, Sept. 2015, pp. 432-6, https://annaliitalianidichirurgia.it/index.php/aic/article/view/1604.
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Vol. 86 No. 5 (2015)
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Article