Over-diagnosis for preoperative T staging of colorectal cancer - A case series
| Autor: | Kazuhito Sasaki, Keisuke Hata, Kazushige Kawai, Hiroaki Nozawa, Manabu Kaneko, Yugo Hirata, Takeshi Nishikawa, Koji Murono, Kensuke Otani, Toshiaki Tanaka |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer Colonoscopy T stage 03 medical and health sciences 0302 clinical medicine Obstruction medicine In patient Pathological Original Research medicine.diagnostic_test business.industry General Medicine Multiplanar reconstruction medicine.disease 030220 oncology & carcinogenesis Over-diagnosis Imaging technology T-stage 030211 gastroenterology & hepatology Surgery Radiology business Over diagnosis |
| Zdroj: | Annals of Medicine and Surgery |
| ISSN: | 2049-0801 |
| Popis: | Introduction Recent progressive imaging technology such as multiplanar reconstruction on computed tomography (CT) and colonoscopy has made preoperative T staging of colorectal cancer (CRC) more accurate. Nevertheless, it is still difficult to make a correct diagnosis in some cases. The aim of this case study was to investigate the accuracy of T staging diagnosis in patients with CRC who underwent curative operations and to identify the causes of preoperative over-diagnosis. Method Medical charts of 1013 colorectal cancer patients who underwent a curative operation in the University of Tokyo Hospital between January 2011 and December 2016 were analyzed retrospectively. We defined a two-level or more difference between clinical and pathological T stages as over-diagnosis or under-diagnosis. Results Nine patients were over-diagnosed in T stage preoperatively. The rate of over-diagnosis was 0.9%. At least three main factors for over-diagnosis were identified: close-to-circumferential or obstructive lesion; a rough appearance in the adipose tissues around the tumor on CT; and a tumor with a depressed structure. Conclusions Clinical T stage is overestimated with a marked difference from pathological T stage in approximately 1% of CRC patients. Further progress in diagnostic modalities is required for more accurate staging. Highlights • The rate of one-level over-diagnosis in T stage was 14.8%. • The rate of two-levels or more over-diagnosis in T stage was 0.9%. • At least three main factors for two-levels or more over-diagnosis were identified. |
| Databáze: | OpenAIRE |
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