Skip to main content

Advertisement

SpringerLink
Log in

Consequences of CT colonography in stenosing colorectal cancer

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

In patients with stenosing colorectal cancer (CRC), visualization of the entire colon prior to surgery is recommended to exclude synchronous tumors. Therefore, most centers combine computed tomographic colonography (CTC) with staging CT. The aims of this study were to evaluate the yield and clinical implications of CTC.

Methods

In this multicenter retrospective study, patients with stenosing CRC that underwent CTC and subsequent surgery between April 2013 and November 2015 were included. Result of the CTC, its influence on the surgical treatment plan, and final histology report were evaluated.

Results

One hundred sixty-two patients with stenosing CRC were included. Nine (5.6 %) synchronous cancers proximal to the stenosing tumor were suspected with CTC. In four of nine patients, the CTC did not change the primary surgical plan because the tumors were located in the same surgical segment. In five of nine patients, CTC changed the surgical treatment plan. Three of these five patients underwent an extended resection and the presence of the tumors was confirmed. Two of these three synchronous CRCs were also visible on abdominal staging CT. In the other two patients, the result of CTC was false positive which led to an unnecessary extended resection in one patient.

Conclusion

The yield of CTC was relatively low. In only three patients (1.9 %), CTC correctly changed the primary surgical plan, but in two of them, the tumor was also visible on abdominal staging CT. Moreover, in two patients, CTC was false positive. The clinical value of CTC in stenosing CRC appears to be limited.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386

    Article  CAS  PubMed  Google Scholar 

  2. Siegel R, Desantis C, Jemal A (2014) Colorectal cancer statistics, 2014. CA Cancer J Clin 64(2):104–117

    Article  PubMed  Google Scholar 

  3. Moreno CC, Mittal PK, Sullivan PS, et al. (2015) Colorectal cancer initial diagnosis: screening colonoscopy, diagnostic colonoscopy, or emergent surgery, and tumor stage and size at initial presentation. Clin Colorectal Cancer

  4. Billingsley KG, Morris AM, Dominitz JA et al (2007) Surgeon and hospital characteristics as predictors of major adverse outcomes following colon cancer surgery: understanding the volume-outcome relationship. Arch Surg 142(1):23–31 discussion 32

    Article  PubMed  Google Scholar 

  5. Deans GT, Krukowski ZH, Irwin ST (1994) Malignant obstruction of the left colon. Br J Surg. 81(9):1270–1276

    Article  CAS  PubMed  Google Scholar 

  6. Serpell JW, McDermott FT, Katrivessis H, Hughes ES (1989) Obstructing carcinomas of the colon. Br J Surg. 76(9):965–969

    Article  CAS  PubMed  Google Scholar 

  7. Ascanelli S, Navarra G, Tonini G et al (2003) Early and late outcome after surgery for colorectal cancer: elective versus emergency surgery. Tumori 89(1):36–41

    PubMed  Google Scholar 

  8. Ohman U (1982) Prognosis in patients with obstructing colorectal carcinoma. Am J Surg 143(6):742–747

    Article  CAS  PubMed  Google Scholar 

  9. Lam AK, Chan SS, Leung M (2014) Synchronous colorectal cancer: clinical, pathological and molecular implications. World J Gastroenterol 20(22):6815–6820

    Article  PubMed  PubMed Central  Google Scholar 

  10. Mulder SA, Kranse R, Damhuis RA et al (2011) Prevalence and prognosis of synchronous colorectal cancer: a dutch population-based study. Cancer Epidemiol 35(5):442–447

    Article  PubMed  Google Scholar 

  11. Adloff M, Arnaud JP, Bergamaschi R, Schloegel M (1989) Synchronous carcinoma of the colon and rectum: prognostic and therapeutic implications. Am J Surg 157(3):299–302

    Article  CAS  PubMed  Google Scholar 

  12. Latournerie M, Jooste V, Cottet V, Lepage C, Faivre J, Bouvier AM (2008) Epidemiology and prognosis of synchronous colorectal cancers. Br J Surg 95(12):1528–1533

    Article  CAS  PubMed  Google Scholar 

  13. Pickhardt PJ, Hassan C, Halligan S, Marmo R (2011) Colorectal cancer: CT colonography and colonoscopy for detection—systematic review and meta-analysis. Radiology 259(2):393–405

    Article  PubMed  PubMed Central  Google Scholar 

  14. Halligan S, Altman DG, Taylor SA et al (2005) CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology 237(3):893–904

    Article  PubMed  Google Scholar 

  15. Mulhall BP, Veerappan GR, Jackson JL (2005) Meta-analysis: computed tomographic colonography. Ann Intern Med 142(8):635–650

    Article  PubMed  Google Scholar 

  16. Park SH, Lee JH, Lee SS et al (2012) CT colonography for detection and characterisation of synchronous proximal colonic lesions in patients with stenosing colorectal cancer. Gut 61(12):1716–1722

    Article  PubMed  Google Scholar 

  17. AGA Clinical Practice and Economics Committee (2006) Position of the american gastroenterological association (AGA) institute on computed tomographic colonography. Gastroenterology 131(5):1627–1628

    Article  Google Scholar 

  18. Hong N, Park SH (2014) CT colonography in the diagnosis and management of colorectal cancer: emphasis on pre- and post-surgical evaluation. World J Gastroenterol 20(8):2014–2022

    Article  PubMed  PubMed Central  Google Scholar 

  19. Cash BD, Rockey DC, Brill JV (2011) AGA standards for gastroenterologists for performing and interpreting diagnostic computed tomography colonography: 2011 update. Gastroenterology 141(6):2240–2266

    Article  PubMed  Google Scholar 

  20. Spada C, Stoker J, Alarcon O et al (2014) Clinical indications for computed tomographic colonography: European society of gastrointestinal endoscopy (ESGE) and european society of gastrointestinal and abdominal radiology (ESGAR) guideline. Endoscopy 46(10):897–915

    Article  PubMed  Google Scholar 

  21. Flor N, Ceretti AP, Mezzanzanica M et al (2013) Impact of contrast-enhanced computed tomography colonography on laparoscopic surgical planning of colorectal cancer. Abdom Imaging 38(5):1024–1032

    Article  PubMed  Google Scholar 

  22. Kim JH, Kim WH, Kim TI et al (2007) Incomplete colonoscopy in patients with occlusive colorectal cancer: usefulness of CT colonography according to tumor location. Yonsei Med J 48(6):934–941

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Sali L, Falchini M, Taddei A, Mascalchi M (2014) Role of preoperative CT colonography in patients with colorectal cancer. World J Gastroenterol 20(14):3795–3803

    Article  PubMed  PubMed Central  Google Scholar 

  24. Johnson CD, Chen M, Toledano AY et al (2008) Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med 359(12):1207–1217

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, P.O. box 10400, Isala, 8000 GK, Zwolle, the Netherlands

    JF Huisman, LW Leicher & WH de Vos tot Nederveen Cappel

  2. Department of Radiology, Isala, Zwolle, the Netherlands

    E de Boer

  3. Department of Surgery, Isala, Zwolle, the Netherlands

    HL van Westreenen

  4. Department of Medical Oncology, Isala, Zwolle, the Netherlands

    JW de Groot

  5. Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands

    FA Holman & KCMJ Peeters

  6. Department of Gastroenterology and Hepatology, Slingeland hospital, Doetinchem, the Netherlands

    PC van de Meeberg

  7. Department of Radiology, Slingeland hospital, Doetinchem, the Netherlands

    PEJM Sallevelt

  8. Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands

    MNJM Wasser

  9. Dept of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands

    HFA Vasen

Authors
  1. JF Huisman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. LW Leicher
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E de Boer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. HL van Westreenen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. JW de Groot
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. FA Holman
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. PC van de Meeberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. PEJM Sallevelt
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. KCMJ Peeters
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. MNJM Wasser
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. HFA Vasen
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. WH de Vos tot Nederveen Cappel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to JF Huisman.

Ethics declarations

This retrospective study was approved by the institutional ethical committees.

Disclosure of interest

None declared.

Financial conflicts

This study was not funded.

Additional information

Huisman JF and Leicher LW equally contributed to this manuscript.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Huisman, J., Leicher, L., de Boer, E. et al. Consequences of CT colonography in stenosing colorectal cancer. Int J Colorectal Dis 32, 367–373 (2017). https://doi.org/10.1007/s00384-016-2683-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-016-2683-6

Keywords

Search

Navigation