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Abdominal Radiology
Published in: Abdominal Radiology 2/2024

29-11-2023 | Colon Cancer | Hollow Organ GI

The diagnostic accuracy of local staging in colon cancer based on computed tomography (CT): evaluating the role of extramural venous invasion and tumour deposits

Authors: K. van den Berg, S. Wang, J. M. W. E. Willems, G. J. Creemers, J. M. L. Roodhart, J. Shkurti, J. W. A. Burger, H. J. T. Rutten, R. G. H. Beets-Tan, J. Nederend

Published in: Abdominal Radiology | Issue 2/2024

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Abstract

Purpose

The shift from adjuvant to neoadjuvant treatment in colon cancer demands the radiological selection of patients for systemic therapy. The aim of this study was to evaluate the accuracy of the CT-based TNM stage and high-risk features, including extramural venous invasion (EMVI) and tumour deposits, in the identification of patients with histopathological advanced disease, currently considered for neoadjuvant treatment (T3-4 disease).

Methods

All consecutive patients surgically treated for non-metastatic colon cancer between January 2018 and January 2020 in a referral centre for colorectal cancer were identified retrospectively. All tumours were staged on CT according to the TNM classification system. Additionally, the presence of EMVI and tumour deposits on CT was evaluated. The histopathological TNM classification was used as reference standard.

Results

A total of 176 patients were included. Histopathological T3-4 colon cancer was present in 85.0% of the patients with CT-detected T3-4 disease. Histopathological T3-4 colon cancer was present in 96.4% of the patients with CT-detected T3-4 colon cancer in the presence of both CT-detected EMVI and CT-detected tumour deposits. Histopathological T0-2 colon cancer was present in 50.8% of the patients with CT-detected T0-2 disease, and in 32.4% of the patients without CT-detected EMVI and tumour deposits.

Conclusion

The diagnostic accuracy of CT-based staging was comparable with previous studies. The presence of high-risk features on CT increased the probability of histopathological T3-4 colon cancer. However, a substantial part of the patients without CT-detected EMVI and tumour deposits was diagnosed with histopathological T3-4 disease. Hence, more accurate selection criteria are required to correctly identify patients with locally advanced disease.
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Metadata
Title
The diagnostic accuracy of local staging in colon cancer based on computed tomography (CT): evaluating the role of extramural venous invasion and tumour deposits
Authors
K. van den Berg
S. Wang
J. M. W. E. Willems
G. J. Creemers
J. M. L. Roodhart
J. Shkurti
J. W. A. Burger
H. J. T. Rutten
R. G. H. Beets-Tan
J. Nederend
Publication date
29-11-2023
Publisher
Springer US
Published in
Abdominal Radiology / Issue 2/2024
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-023-04094-7

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