Over-diagnosis for preoperative T staging of colorectal cancer - A case series

Annals of Medicine and Surgery
Yugo HirataManabu Kaneko

Abstract

Recent progressive imaging technology such as multiplanar reconstruction on computed tomography (CT) and colonoscopy has made preoperative T staging of colorectal cancer (CRC) more accurate. Nevertheless, it is still difficult to make a correct diagnosis in some cases. The aim of this case study was to investigate the accuracy of T staging diagnosis in patients with CRC who underwent curative operations and to identify the causes of preoperative over-diagnosis. Medical charts of 1013 colorectal cancer patients who underwent a curative operation in the University of Tokyo Hospital between January 2011 and December 2016 were analyzed retrospectively. We defined a two-level or more difference between clinical and pathological T stages as over-diagnosis or under-diagnosis. Nine patients were over-diagnosed in T stage preoperatively. The rate of over-diagnosis was 0.9%. At least three main factors for over-diagnosis were identified: close-to-circumferential or obstructive lesion; a rough appearance in the adipose tissues around the tumor on CT; and a tumor with a depressed structure. Clinical T stage is overestimated with a marked difference from pathological T stage in approximately 1% of CRC patients. Further progress in diagnosti...Continue Reading

Citations

Aug 16, 2019·Der Radiologe·I Iesalnieks, A Agha

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