Routine preoperative chest computed tomography does not influence therapeutic strategy in patients with colorectal cancer

Autor:	S Piga, Angelo Restivo, Giuseppe Casula, Luigi Zorcolo, Ivana Maria Francesca Cocco
Rok vydání:	2012
Předmět:	medicine.medical_specialty medicine.diagnostic_test business.industry Colorectal cancer Gastroenterology Statistical difference Cancer Computed tomography medicine.disease Group B Surgery Clinical Practice Medicine In patient Radiology business Therapeutic strategy
Zdroj:	Colorectal Disease. 14:e216-e221
ISSN:	1462-8910
DOI:	10.1111/j.1463-1318.2012.02878.x
Popis:	Aim Patients with lung metastasis from colorectal cancer(CRC) may benefit from surgical resection. Chest com-puted tomography (CT) is often included in the preop-erative staging. Interpretation of the nature of pulmonarylesions is not always easy and many question its clinicalvalue.Method Clinical data for all patients treated at ourinstitution for CRC have been collected prospectively in adedicated database. Since August 2008 chest CT hasbeen routinely performed for preoperative staging. Theoutcome of 147 patients operated on since then (GroupA) was compared with a numerically equal group ofpatients (147) (Group B) treated before the introductionof preoperative routine chest CT.Results Pulmonary lesions were identified in 45 (30%)patients in Group A and 10 (6.8%) in Group B. Ten andnine lesions, respectively, were interpreted as metastases.In 28 (19%) patients in Group A, the lesions wereconsidered to be indeterminate and only four wereconfirmed as malignant. Overall metastases were presentafter 1 year of follow-up in 5 (50%) of 10 patients inGroup A and 5 (55%) of 9 in Group B. The globalincidence of synchronous and metachronous metastaseswas 6.8%, with no statistical difference between the twogroups.Conclusion This study shows that chest CT reveals ahigher number of pulmonary lesions, only a smallproportion of which were malignant. The investigationdoes not add value to routine staging methods in patientswith CRC.What is new in this paper?Recent guidelines advocate a routine chest CT scan aspart of the preoperative staging for patients withcolorectal cancer. The present paper is one of the firstto show that routine chest CT does not have a criticalinfluence on clinical practice and therapeutic decision-making.
Databáze:	OpenAIRE
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