» Articles » PMID: 24783181

The Availability of Computed Tomography for Pulmonary Staging in Colorectal Cancer

Overview
Specialty General Surgery
Date 2014 May 1
PMID 24783181
Authors
Affiliations
Soon will be listed here.
Abstract

Purpose: Chest computed tomography is performed frequently for the preoperative pulmonary staging in colorectal cancers (CRCs) regardless of the result of chest x-ray (CXR) due to its high sensitivities and specificities. The advancement of CT technology detects more indeterminate lung lesions that may require further investigations, referrals and follow-up. The aim of this study was to suggest a guideline for performing chest CT for preoperative pulmonary staging in colorectal cancer.

Methods: We performed a retrospective analysis of the records of patients who had chest CT preformed without the evidence of metastasis on CXR for preoperative pulmonary staging.

Results: Of 21 patients with metastatic nodules on chest CT, 23.8% showed pulmonary metastasis on positron emission tomography, 47.6% showed extrapulmonary metastasis on preoperative evaluation and 61.9% showed elevated serum carcinoembryonic antigen level above 10 ng/mL. These results showed significant value compared to patients without metastatic nodules. But, in analyzing patients with or without indeterminate nodules in the three contents listed above, there was no significance.

Conclusion: In the patients with CRC who show normal CXR and exhibit positivity in PET, preoperative extrapulmonary metastasis and elevated serum CEA level above 10 ng/mL preoperatively, chest CT would be helpful in preoperative staging.

References
1.
Kirke R, Rajesh A, Verma R, Bankart M . Rectal cancer: incidence of pulmonary metastases on thoracic CT and correlation with T staging. J Comput Assist Tomogr. 2007; 31(4):569-71. DOI: 10.1097/rct.0b013e318032e8c9. View

2.
Povoski S, Fong Y, Sgouros S, Kemeny N, Downey R, Blumgart L . Role of chest CT in patients with negative chest x-rays referred for hepatic colorectal metastases. Ann Surg Oncol. 1998; 5(1):9-15. DOI: 10.1007/BF02303757. View

3.
Grossmann I, Avenarius J, Mastboom W, Klaase J . Preoperative staging with chest CT in patients with colorectal carcinoma: not as a routine procedure. Ann Surg Oncol. 2010; 17(8):2045-50. PMC: 2899025. DOI: 10.1245/s10434-010-0962-y. View

4.
Brent A, Talbot R, Coyne J, Nash G . Should indeterminate lung lesions reported on staging CT scans influence the management of patients with colorectal cancer?. Colorectal Dis. 2007; 9(9):816-8. DOI: 10.1111/j.1463-1318.2007.01229.x. View

5.
Murata K, Takahashi M, Mori M, Kawaguchi N, Furukawa A, Ohnaka Y . Pulmonary metastatic nodules: CT-pathologic correlation. Radiology. 1992; 182(2):331-5. DOI: 10.1148/radiology.182.2.1732945. View