Diagnostic Accuracy of Abdominal CT for Locally Advanced Colon Tumors: Can We Really Entrust Certain Decisions to the Reliability of CT?

Many different options of neoadjuvant treatments for advanced colon cancer are emerging. An accurate preoperative staging is crucial to select the most appropriate treatment option. A retrospective study was carried out on a national series of operated patients with T4 tumors. Considering the anatom...

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Detalles Bibliográficos
Autores: García del Álamo Hernández, Yaiza, Cano Valderrama, Óscar, Cerdán Santacruz, Carlos, Pereira Pérez, Fernando, Aldrey Cao, Inés, Núñez Fernández, Sandra, Álvarez Sarrado, Eduardo, Obregón Reina, Rosángela, Dujovne Lindenbaum, Paula, Taboada Ameneiro, María, Ambrona Zafra, David, Pérez Farré, Silvia, Pascual Damieta, Marta, Frago Montanuy, Ricardo, Flor Lorente, Blas, Biondo, Sebastiano, Collaborative Group For The Study Of Metachronous Peritoneal Metastases Of Pt4 Colon Cancer
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/204328
Acceso en línea:https://hdl.handle.net/2445/204328
Access Level:acceso abierto
Palabra clave:Càncer colorectal
Tomografia
Colorectal cancer
Tomography
Descripción
Sumario:Many different options of neoadjuvant treatments for advanced colon cancer are emerging. An accurate preoperative staging is crucial to select the most appropriate treatment option. A retrospective study was carried out on a national series of operated patients with T4 tumors. Considering the anatomo-pathological analysis of the surgical specimen as the gold standard, a diagnostic accuracy study was carried out on the variables T and N staging and the presence of peritoneal metastases (M1c). The parameters calculated were sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios, as well as the overall accuracy. A total of 50 centers participated in the study in which 1950 patients were analyzed. The sensitivity of CT for correct staging of T4 colon tumors was 57%. Regarding N staging, the overall accuracy was 63%, with a sensitivity of 64% and a specificity of 62%; however, the positive and negative likelihood ratios were 1.7 and 0.58, respectively. For the diagnosis of peritoneal metastases, the accuracy was 94.8%, with a sensitivity of 40% and specificity of 98%; in the case of peritoneal metastases, the positive and negative likelihood ratios were 24.4 and 0.61, respectively. The diagnostic accuracy of CT in the setting of advanced colon cancer still has some shortcomings for accurate diagnosis of stage T4, correct classification of lymph nodes, and preoperative detection of peritoneal metastases.

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