Clinical Usefulness of Chest Radiography in Detection of Pulmonary Metastases After Curative Resection for Colorectal Cancer

The purpose of this study was to evaluate the effectiveness of chest radiography (CXR) and abdominal computed tomography (CT) for detecting pulmonary metastases after curative surgery for colorectal cancer.

We performed a retrospective analysis of the records of all patients with pulmonary metastasis from colorectal cancer who underwent curative resection between 1994 and 2004 at our institution.

Pulmonary metastases were detected in 193 patients by either CXR or abdominal CT. They were initially detected by CXR in 87 patients (45.1%) and by abdominal CT in 106 patients (54.9%). In the CXR group, the patterns of pulmonary recurrence were as follows: solitary (n = 38, 43.7%), multiple unilateral (n = 11, 12.6%), and multiple bilateral (n = 38, 43.7%). In the CT group, there were 22 patients (20.8%) with a solitary nodule, 17 patients (16.0%) with multiple unilateral nodules, and 67 (63.2%) with multiple bilateral nodules. The overall survivals of the CXR group and abdominal CT group were 34.6% and 31.7%, respectively (p = 0.312). There was no difference in the median disease-free interval between the CXR group and the abdominal CT group (23.8 vs. 23.2 months, p = 0.428).

Although this study is limited by its small sample size, it can be speculated that abdominal CT with lower thorax images may replace CXR in surveillance programs.