J Korean Surg Soc.  2011 May;80(5):327-333. 10.4174/jkss.2011.80.5.327.

Routine chest computed tomography as a preoperative work-up for primary colorectal cancer: is there any benefit in short-term outcome?

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. cyk1010@lycos.co.kr
  • 2Department of Surgery, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
The aim of this study was to assess the role of pre-operative chest computed tomography (CT) compared with abdominopelvic CT (AP-CT) and chest radiography (CXR) for detecting pulmonary metastasis in patients with primary colorectal cancer (CRC).
METHODS
We retrospectively analyzed the data of 619 patients with primary CRC who simultaneously received a preoperative chest CT (chest CT group), AP-CT with hilar extension, and CXR (CXR group).
RESULTS
In the chest CT group, there were 297 (48.0%) normal, 198 (32%) benign, 96 (15.5%) indeterminate, 26 (4.2%) metastasis, and two lung cancers. Eighteen patients (2.9%) in the CXR group who had no pulmonary metastasis were diagnosed with pulmonary metastasis on a chest CT. The sensitivity and accuracy were 83.9% and 99.0% in the chest CT group, respectively, and 29.0% and 91.5% in the CXR group, respectively (P < 0.0001 and P = 0.0003).
CONCLUSION
Chest CT appears to improve the accuracy of pre-operative staging in patients with CRC and is useful for the early detection of pulmonary metastasis as a baseline study for abnormal lung nodules.

Keyword

Colorectal neoplasm; Metastases; Computed tomography; Chest X-ray

MeSH Terms

Colorectal Neoplasms
Humans
Lung
Lung Neoplasms
Neoplasm Metastasis
Retrospective Studies
Thorax

Figure

  • Fig. 1 Classification of the radiologic findings. (A) Normal. (B) Benign. (C) Metastatic. (D) Indeterminate.

  • Fig. 2 Characteristics of the chest computed tomography (CT) group. F/U, follow-up. a)Thymoma (1), thyroid ca (1). b)Size <5 mm, without calcification.

  • Fig. 3 Characteristics of the chest radiography (CXR) group. AP-CT, abdominopelvic-computed tomography.

  • Fig. 4 Treatment of the pulmonary metastases. VATS, video-assisted thoracoscopic surgery.


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