Endoscopic ultrasonography and computed tomography scanning for preoperative staging of colonic cancer

TY - JOUR

T1 - Endoscopic ultrasonography and computed tomography scanning for preoperative staging of colonic cancer

AU - Malmstrøm, M L

AU - Gögenur, I

AU - Riis, L B

AU - Hassan, H

AU - Klausen, T W

AU - Perner, T

AU - Săftoiu, A

AU - Vilmann, P

PY - 2017/6/1

Y1 - 2017/6/1

N2 - Purpose: With an increasing demand for more accurate preoperative staging methods for colon cancer, we aimed to compare preoperative tumour (T)- and nodal (N)-stage in patients with left-sided colon cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) with post-operative histology as gold standard. Methods: A total of 44 patients were prospectively recruited at Herlev and Roskilde University Hospitals during November 2014–January 2016. Thirty-five patients were included in the final analysis and underwent EUS, CT and surgery within 2 weeks. Diagnostic values were evaluated for “low risk” (T1+T2+T3 with ≤5 mm extramural invasion) and “high risk” (T3 with >5 mm of extramural spread + T4) colonic cancer. Results: Sensitivity and specificity in “low risk” colonic cancer evaluated with EUS was 0.90 [0.74;0.98] and 0.75 [0.19;0.99] and with CT 0.96 [0.80;0.99] and 0.25 [<0.01;0.81]. EUS and CT were poor in predicting N0 or N+ disease. Conclusions: The sensitivity of EUS and CT were good and comparable regarding T-stage evaluation, while EUS had a significantly higher specificity in the evaluation of “low risk” tumours. The results obtained for “high risk” colonic cancer were difficult to evaluate due to small patient numbers. EUS could be considered as a supplement to CT scans in selecting patients for neoadjuvant therapies, or local transmural treatment, in the future. Trial registration: NCT02324023.

AB - Purpose: With an increasing demand for more accurate preoperative staging methods for colon cancer, we aimed to compare preoperative tumour (T)- and nodal (N)-stage in patients with left-sided colon cancer by endoscopic ultrasonography (EUS) and computed tomography (CT) with post-operative histology as gold standard. Methods: A total of 44 patients were prospectively recruited at Herlev and Roskilde University Hospitals during November 2014–January 2016. Thirty-five patients were included in the final analysis and underwent EUS, CT and surgery within 2 weeks. Diagnostic values were evaluated for “low risk” (T1+T2+T3 with ≤5 mm extramural invasion) and “high risk” (T3 with >5 mm of extramural spread + T4) colonic cancer. Results: Sensitivity and specificity in “low risk” colonic cancer evaluated with EUS was 0.90 [0.74;0.98] and 0.75 [0.19;0.99] and with CT 0.96 [0.80;0.99] and 0.25 [<0.01;0.81]. EUS and CT were poor in predicting N0 or N+ disease. Conclusions: The sensitivity of EUS and CT were good and comparable regarding T-stage evaluation, while EUS had a significantly higher specificity in the evaluation of “low risk” tumours. The results obtained for “high risk” colonic cancer were difficult to evaluate due to small patient numbers. EUS could be considered as a supplement to CT scans in selecting patients for neoadjuvant therapies, or local transmural treatment, in the future. Trial registration: NCT02324023.

KW - Adenocarcinoma/diagnostic imaging

KW - Aged

KW - Aged, 80 and over

KW - Colonic Neoplasms/diagnostic imaging

KW - Demography

KW - Endosonography

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Neoplasm Staging

KW - Preoperative Care

KW - Risk Factors

KW - Tomography, X-Ray Computed

U2 - 10.1007/s00384-017-2820-x

DO - 10.1007/s00384-017-2820-x

M3 - Journal article

C2 - 28432444

SN - 0179-1958

VL - 32

SP - 813

EP - 820

JO - International Journal of Colorectal Disease

JF - International Journal of Colorectal Disease

IS - 6

ER -