Pre-colectomy location and TNM staging of colon cancer by the computed tomography colonography: a diagnostic performance study

World Journal of Surgical Oncology

Fafu Dou¹  Yadong Zhou¹  Zhiwei Han²  Tao Yan³ 

[1] Department of Gastrointestinal Surgery, 3201 Hospital, 723000, Hanzhong, Shaanxi, China;Department of Radiology, Air Force Medical University, 710032, Xi’an, Shaanxi, China;Department of Radiology, Xian XD Group Hospital, 710077, Xi’an, Shaanxi, China;

关键词: Colonoscopy;    Local staging of colon cancer;    Tumor location;    Treatment plan;    Virtual colonoscopy;   

DOI  :  10.1186/s12957-021-02215-4

来源: Springer

【 摘 要 】

BackgroundThe Chinese Society of Clinical Oncology guidelines 2018 and the recent update of that (version 2020) recommends accurate examination before major treatment for decision(s) in cases of colon cancer. Also, the difficulty in the identification of the lesion during colectomy may lead to resection of a wrong segment of the colon or a more extensive resection than planned. Accurate pre-colectomy local staging of colon cancer is required to make decisions for treatment of colon cancer. The objective of the study was to evaluate the diagnostic performance of the computed tomography colonography (CTC) for pre-colectomy tumor location and tumor, node, and metastasis (TNM) staging of colon cancer.MethodsData of preoperative colonoscopies, CTC, surgeries, and surgical pathology of a total of 269 patients diagnosed with colon cancer by colonoscopy and biopsy and underwent pre-colectomy location and TNM staging by CTC were collected and analyzed. The consistency between the radiological and the surgery/surgical-pathological for location and TN stages of colon tumor were estimated with the weighted kappa or kappa coefficient (κ) at 95% confidence interval (CI).ResultsCTC detected 261 (93%) and colonoscopy detected 201 (72%) correct locations of tumors. Sensitivity and accuracy of CTC for detection of location of colon tumors were 100% and 92.58% (κ = 0.89; 95% Cl: 0.83–0.95). 72.48% sensitivity, 90.64% specificity, and 83.57% accuracy were reported for CTC in differentiation of tumors confined to the colon wall (T1/T2) from advanced tumors (T3/T4) (κ = 0.69, 95% Cl: 0.51–0.75). 81.01% sensitivity, 89.11% specificity, and 83.93% accuracy of CTC was reported for differentiation of tumors between low–intermediate risk and high risk (κ = 0.68, 95% Cl: 0.53–0.75). 69.31% sensitivity, 66.15% specificity, and 67.14% accuracy of CTC were reported for N staging of tumors (κ = 0.41, 95% Cl: 0.59–0.69).ConclusionsCTC has high diagnostic parameters for pre-colectomy location and T staging of colon tumors except patients of colon cancer who received neoadjuvant chemotherapy.Level of EvidenceIII.Technical Efficacy Stage2.

【 授权许可】

CC BY