Location of colorectal cancer: colonoscopy versus surgery. Yield of colonoscopy in predicting actual location

Abstract

Background and study aims Recent studies suggest that differences in biological characteristics and risk factors across cancer site within the colon and rectum may translate to differences in survival. It can be challenging at times to determine the precise anatomical location of a lesion with a luminal view during colonoscopy. The aim of this study is to determine if there is a significant difference between the location of colorectal cancers described by gastroenterologists in colonoscopies and the actual anatomical location noted on operative and pathology reports after colon surgery. Patients and methods A single-center retrospective analysis of colonoscopies of patient with reported colonic masses from January 2005 to April 2014 (n = 380) was carried. Assessed data included demography, operative and pathology reports. Findings were compared: between the location of colorectal cancers described by gastroenterologists in colonoscopies and the actual anatomical location noted on operative reports or pathology samples. Results We identified 380 colonic masses, 158 were confirmed adenocarcinomas. Of these 123 underwent surgical resection, 27 had to be excluded since no specific location was reported on their operative or pathology report. An absolute difference between endoscopic and surgical location was found in 32 cases (33 %). Of these, 22 (23 %) differed by 1 colonic segment, 8 (8 %) differed by 2 colonic segments and 2 (2 %) differed by 3 colonic segments. Conclusion There is a significant difference between the location of colorectal cancers reported by gastroenterologists during endoscopy and the actual anatomical location noted on operative or pathology reports after colon surgery. Endoscopic tattooing should be used when faced with any luminal lesions of interest.

Transanal total mesorectal excision: how are we doing so far?

“…In the present study, tumour location was derived from endoscopy. There seems to be a significant difference between the tumour location of colorectal cancers reported by endoscopy and the actual location determined during surgery . Moreover, the anal verge was the reference for determination of the tumour location.…”

The relationship between colon polyps and colonic diverticulosis: a retrospective review

“…This finding may reflect the angulation of the sigmoid colon and perhaps a greater likelihood of overlooking polyps. However, it may also reflect incorrect localization of polyps, as the prior literature indicates that gastroenterologists can be incorrect in predicting the location of the colon cancer and our data is based on gastroenterologists’ suspected location of colonic neoplasms [ 8 ].…”

Impact of routine preoperative 18FDG PET/CT on the surgical management of primary colorectal cancer

“…The lack of knowledge of precise tumor localization during surgery may have a negative impact on surgical performance. According to Blum‐Guzman et al 11 and Acuna et al, 4 incorrect tumor location occurs in 15.4%–33% of colonoscopies. These authors have suggested that complementary techniques should be used to improve outcomes, as conventional colonoscopy alone may be inadequate.…”