| Preoperative staging with chest CT in patients with colorectal carcinoma: not as a routine procedure. | |
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MedLine Citation:
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PMID: 20151212 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Preoperative staging of patients with colorectal carcinoma (CRC) has the potential benefit of altering treatment options when metastases are present. The clinical value of chest computed tomography (CT) in staging remains unclear. MATERIALS AND METHODS: All patients who undergo colorectal surgery in our hospital are prospectively registered, including patient, treatment, and histopathological characteristics; outcome; and follow-up. Since January 2007, routine preoperative staging CT of chest and abdomen for patients with CRC has been performed as part of our regional guidelines. In this observational cohort study, an analysis on outcome was done after inclusion of 200 consecutive patients. RESULTS: Synchronous metastases were present in 60 patients (30%). Staging chest CT revealed pulmonary metastases in 6 patients, with 1 false positive finding. In 50 patients indeterminate lesions were seen on chest CT (25%). These were diagnosed during follow-up as true metastases (n = 8), bronchus carcinoma (n = 2), benign lesions (n = 25), and remaining unknown (n = 15). Ultimately, synchronous pulmonary metastases were diagnosed in 13 patients (7%), in 6 patients confined to the lung (3%). In none of the patients the treatment plan for the primary tumor was changed based on the staging chest CT. CONCLUSION: The low incidence of pulmonary metastases and minimal consequences for the treatment plan limits the clinical value of routine staging chest CT before operation. It has several disadvantages such as costs, radiation exposure, and prolonged uncertainty because of the frequent finding of indeterminate lesions. Based on this study, a routine staging chest CT in CRC patients is not advocated. |
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Authors:
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Irene Grossmann; Johannes K A Avenarius; Walter J B Mastboom; Joost M Klaase |
Publication Detail:
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Type: Journal Article Date: 2010-02-12 |
Journal Detail:
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Title: Annals of surgical oncology Volume: 17 ISSN: 1534-4681 ISO Abbreviation: Ann. Surg. Oncol. Publication Date: 2010 Aug |
Date Detail:
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Created Date: 2010-07-08 Completed Date: 2010-10-27 Revised Date: 2012-01-11 |
Medline Journal Info:
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Nlm Unique ID: 9420840 Medline TA: Ann Surg Oncol Country: United States |
Other Details:
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Languages: eng Pagination: 2045-50 Citation Subset: IM |
Affiliation:
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Department of Surgery, Medical Spectrum Twente, Enschede, The Netherlands. irenegrossmann@me.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Colorectal Neoplasms / pathology*, radiography Female Follow-Up Studies Humans Lung Neoplasms / radiography*, secondary* Male Middle Aged Neoplasm Staging / methods* Preoperative Care* Prospective Studies Tomography, X-Ray Computed* |
| Comments/Corrections | |
Comment In:
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Ann Surg Oncol. 2011 Dec;18 Suppl 3:S224-5; author reply S226-7
[PMID:
20839065
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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