Comparative analysis of colorectal carcinoma staging using operative, histopathology and computed tomography findings

Abstract

Background:The staging of colorectal carcinoma using 3 modalities viz operative, histopathology and CT scan has been subject of interest in accurately defining the extent of disease. This retrospective as well as prospective study was carried out at CMC, Ludhiana, Punjab from November 2011 to May 2014.Aim:The objective of this study was to assess the usefulness and accuracy of CT scan findings to state the extent and spread of colorectal malignancy and to correlate these findings with histopathological diagnosis.Method:A total of 31 biopsy proven patients showing variable bowel wall thickening involving the colon /rectum on CECT (Contrast Enhanced Computed Tomography) were included in the study. The tumours were staged based on the CT scan findings and were compared with the operative and histopathological findings.Observations:Rectum was the most common site of involvement followed by the recto-sigmoid involvement. Metastasis was observed in 5 cases out of the 31 malignant cases. Five of the 7 cases were correctly staged as T1 & T2 lesions on CT having a sensitivity of 83.3%, specificity of 92%, and positive predictive value of 71.4% and a negative predictive value of 95.8% in the diagnosis of T1 and T2 lesions. 15 of the 16 cases were correctly staged as T3 lesions. CT had a sensitivity of 88.2%, specificity of 93.8%, and positive predictive value of 93.8% and a negative predictive value of 86.7% in the diagnosis of T3 lesions. All the 8 cases were correctly staged as T4 lesions. CT had a sensitivity of 100%, specificity of 100%, and positive predictive value of 100% and a negative predictive value of 100% in the diagnosis of T4 lesions.Conclusion:We conclude that CT scan is an excellent modality in diagnosing malignant lesions of the colon and rectum.

Diagnostic Accuracy of Multidetector Computed Tomography in Detecting Mesorectal Fascia Involvement in Colorectal Carcinoma

“…Planning, CT is being used for pre-operative assessment of the growth and involvement of adjacent structures, including the fat and pelvis muscles. [16][17][18] In a study, the percentage of carcinoma of the colon was 60%. The accuracy of detection of CRC in poorly prepared bowel on CT is documented to have an accuracy of approx.…”

“…Recently, few reports have shown that computed tomography (CT) staging in rectal cancer is quite accurate in estimating the extent of the disease and helpful in planning the treatment of rectal cancer. 16,17 CT is used to stage rectal.…”

A histopathological analysis of colorectal cancer

“…In present study tumor type was adenocarcinoma in 76, mucinous adenocarcinoma in 23, malign melanoma in 6, signet ring cell carcinoma in 4, gastrointesitnal stromal tumor in 2 and endometriosis in 1 case. Singla et al [9] found that rectum was the most common site of involvement followed by the recto-sigmoid involvement. Metastasis was observed in 5 cases out of the 31 malignant cases.…”

Long‐term oncological outcomes of local excision versus radical resection for early colorectal cancer in young patients without preoperative chemoradiotherapy: a population‐based propensity matching study

“…The risk for regional lymph node metastasis is reported up to 14 percents of patients with T1 colorectal cancer . Combing risk factors of lymph node metastasis, including large tumor size, old age, lymphatic invasion, submucosal invasion (≥1 mm), and poor differentiation, with high‐resonance magnetic imaging and computed tomography , surgeons can identify patients with lower risk for lymph node metastasis, which are, by definition, clinic N0.…”