Synchronous colorectal cancer using CT colonography vs. other means: a systematic review and meta-analysis

Flor, Nicola; Zanchetta, Edoardo; Leo, Giovanni Di; Mezzanzanica, Miriam; Greco, Massimiliano; Carrafiello, Gianpaolo; Sardanelli, Francesco

doi:10.1007/s00261-018-1658-1

Cited by 14 publications

(15 citation statements)

References 65 publications

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“…Moreover, stent of an obstructing cancer is yet to be recommended as a standard treatment, and colonoscopy may be dangerous through a colonic stent even though feasible[ 26 ]. The colon may also be satisfactorily evaluated with imaging modalities (virtual coloscopy, CT-colonography, magnetic resonance colonography, intra-operative or post-operative coloscopy)[ 1 , 15 , 20 , 27 ]. Thus, every reasonable effort should be made to evaluate the entire colon before planning definitive intervention[ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Three colonic cancers, two sites of complete occlusion, one patient: A case report

Bergeron¹,

Manière²,

Vien³

et al. 2021

WJGS

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BACKGROUND Synchronous colonic cancer incidence is uncommon, and awareness about this rare condition is improved recently. However, in the presence of acute colonic obstruction, investigation and management of synchronous colonic cancer can be difficult and challenging. CASE SUMMARY A patient presented with acute colonic obstruction with impending rupture and complete examination of this patient revealed the presence of three colonic cancers, of which two were completely occluding. CONCLUSION The presence of multiple colonic cancers must be ruled out in order to plan the best management. We present the case with a review of literature and discuss the management of the case.

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Section: Discussionmentioning

confidence: 99%

Three colonic cancers, two sites of complete occlusion, one patient: A case report

Bergeron¹,

Manière²,

Vien³

et al. 2021

WJGS

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“…Além disso, houve uma particularidade no caso, uma vez que os tumores acometeram o mesmo segmento. 10 No caso descrito, houve a realização completa da colonoscopia, porém não houve a detecção do CCRs, sendo apenas identificado no pós-operatório. Chin, Kuo e Chiang 8 afirmam que o diagnóstico préoperatório preciso de CCRs é fundamental para definir o tipo e a extensão dos tratamentos cirúrgicos.…”

Section: Discussionunclassified

“…Essas lesões adicionais precisam ser distintamente separadas por pelo menos 4cm de distância do CCR índice e não podem constar disseminação de submucosa ou ser uma lesão satélite do CCR índice. 8,10 O CCR geralmente é assintomático, por isso é importante que medidas preventivas sejam implantadas como forma de se detectar a doença em estágio inicial, proporcionando ao paciente mais chances de obter a cura. Além disso, deve-se atentar aos sinais e sintomas de alerta que fazem parte do quadro clínico da doença, como mudanças nos hábitos intestinais, dor abdominal, sangue oculto e alterações nas fezes.…”

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Câncer Colorretal Sincrônico: Relato De Caso

Baldim¹,

Baldim²,

Baldim³

et al. 2021

RECIMA21

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Introdução: o câncer (CA) colorretal é considerado um grave problema de saúde pública, principalmente nos países desenvolvido. Este tipo de tumor apresenta uma alta taxa de mortalidade, e seu diagnóstico precoce pode contribuir para o tratamento e cura da doença. Diante disso, este estudo trouxe um relato de caso de paciente atendido em um hospital na cidade de Alfenas, MG, que foi diagnosticado com câncer colorretal sincrônico (CCRs). Relato de caso: paciente G.V.C., sexo masculino, 65 anos, natural e residente de Alfenas-MG. O paciente buscou atendimento médico, por estar sentindo fortes dores abdominais, foi submetido à avaliações clinicas, laboratoriais e de imagem, as quais constaram a presença de CA de colorretal em estadiamento T3N0. O paciente recebeu tratamento e acompanhamento adequados. Discussão: neste estudo ficou evidente a importância da busca por auxílio médico diante dos primeiros sinais e sintomas apresentados pela doença. Somado a isso, avaliações devem ser realizadas para rastreio possibilitando o diagnostico precoce para que o tratamento curse de forma adequada à manutenção da saúde e da vida do paciente.

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“…Incomplete colonoscopy for neoplastic lesions -CTC Almost all cases of incomplete optical colonoscopy due to occlusive cancer can be examined successfully with CTC [24,25] and one study showed that preoperative CTC, after an incomplete optical colonoscopy, contributed to a change in the surgical plan in 14 of 65 patients (21.5%). Up to 35.1% (range 22.3 % -45.4 %) of synchronous neoplasms occur in one or more different segments from the distal tumor so their detection will change management in a significant number of patients [26].…”

Section: Completion Of a Previously Incomplete Colonoscopymentioning

confidence: 99%

Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline – Update 2020

et al. 2020

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Main recommendations 1 ESGE/ESGAR recommend computed tomographic colonography (CTC) as the radiological examination of choice for the diagnosis of colorectal neoplasia.Strong recommendation, high quality evidence.ESGE/ESGAR do not recommend barium enema in this setting.Strong recommendation, high quality evidence. 2 ESGE/ESGAR recommend CTC, preferably the same or next day, if colonoscopy is incomplete. The timing depends on an interdisciplinary decision including endoscopic and radiological factors.Strong recommendation, low quality evidence.ESGE/ESGAR suggests that, in centers with expertise in and availability of colon capsule endoscopy (CCE), CCE preferably the same or the next day may be considered if colonoscopy is incomplete.Weak recommendation, low quality evidence. 3 When colonoscopy is contraindicated or not possible, ESGE/ESGAR recommend CTC as an acceptable and equally sensitive alternative for patients with alarm symptoms.Strong recommendation, high quality evidence.Because of lack of direct evidence, ESGE/ESGAR do not recommend CCE in this situation.Very low quality evidence.ESGE/ESGAR recommend CTC as an acceptable alternative to colonoscopy for patients with non-alarm symptoms.Strong recommendation, high quality evidence.In centers with availability, ESGE/ESGAR suggests that CCE may be considered in patients with non-alarm symptoms.Weak recommendation, low quality evidence. 4 Where there is no organized fecal immunochemical test (FIT)-based population colorectal screening program, ESGE/ESGAR recommend CTC as an option for colorectal cancer screening, providing the screenee is adequately informed about test characteristics, benefits, and risks, and depending on local service- and patient-related factors.Strong recommendation, high quality evidence.ESGE/ESGAR do not suggest CCE as a first-line screening test for colorectal cancer.Weak recommendation, low quality evidence. 5 ESGE/ESGAR recommend CTC in the case of a positive fecal occult blood test (FOBT) or FIT with incomplete or unfeasible colonoscopy, within organized population screening programs.Strong recommendation, moderate quality evidence.ESGE/ESGAR also suggest the use of CCE in this setting based on availability.Weak recommendation, moderate quality evidence. 6 ESGE/ESGAR suggest CTC with intravenous contrast medium injection for surveillance after curative-intent resection of colorectal cancer only in patients in whom colonoscopy is contraindicated or unfeasibleWeak recommendation, low quality evidence.There is insufficient evidence to recommend CCE in this setting.Very low quality evidence. 7 ESGE/ESGAR suggest CTC in patients with high risk polyps undergoing surveillance after polypectomy only when colonoscopy is unfeasible.Weak recommendation, low quality evidence.There is insufficient evidence to recommend CCE in post-polypectomy surveillance.Very low quality evidence. 8 ESGE/ESGAR recommend against CTC in patients with acute colonic inflammation and in those who have recently undergone colorectal surgery, pending a multidisciplinary evaluation.Strong recommendation, low quality evidence. 9 ESGE/ESGAR recommend referral for endoscopic polypectomy in patients with at least one polyp ≥ 6 mm detected at CTC or CCE.Follow-up CTC may be clinically considered for 6 – 9-mm CTC-detected lesions if patients do not undergo polypectomy because of patient choice, comorbidity, and/or low risk profile for advanced neoplasia.Strong recommendation, moderate quality evidence.

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Synchronous colorectal cancer using CT colonography vs. other means: a systematic review and meta-analysis

Abstract: The prevalence of synchronous CRC was about 4-6%. The introduction of CTC is associated with a significant increase of the prevalence of synchronous CRCs.

Cited by 14 publications

References 65 publications

Three colonic cancers, two sites of complete occlusion, one patient: A case report

Three colonic cancers, two sites of complete occlusion, one patient: A case report

Câncer Colorretal Sincrônico: Relato De Caso

Imaging alternatives to colonoscopy: CT colonography and colon capsule. European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline – Update 2020

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