Preoperative chest computerized tomography in patients with locally advanced mid or lower rectal cancer

Its role in staging and impact on treatment strategy

Dong Jin Choi, Jung-Myun Kwak, Jin Kim, Si Uk Woo, Seon Hahn Kim

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objectives Pulmonary metastasis is frequent in rectal cancer. Some guidelines recommend chest computerized tomography (CT) for preoperative workup in rectal cancer patients, which have no solid evidence to support this recommendation. This study was designed to evaluate the role of chest CT on preoperative staging in rectal cancer patients and to assess the impact on treatment strategy. Methods Data were prospectively collected from 103 clinically T3/T4 mid or lower rectal cancer patients who had chest X-ray (CXR) and CT to evaluate lung metastasis. The chest images were classified into four groups: metastasis, indeterminate, benign, and negative. Patients showing indeterminate lesions had follow-up CTs at 3-to 6-month intervals. Results Nine patients (8.7%) had pulmonary metastases detected on CT. CXR did not reveal any pulmonary metastatic lesions in four of the nine patients. Of these four, treatment was changed in three patients because of these findings. Forty (38.8%) patients had indeterminate nodules on chest CT. Of these, 37 patients had follow-up CTs and four patients (10.8%) showed interval changes that were confirmed as pulmonary metastasis. Conclusions It seems reasonable to perform chest CT for preoperative staging in patients with T3/T4 mid or lower rectal cancer.

Original languageEnglish
Pages (from-to)588-592
Number of pages5
JournalJournal of Surgical Oncology
Volume102
Issue number6
DOIs
Publication statusPublished - 2010 Nov 1

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Rectal Neoplasms
Thorax
Tomography
Neoplasm Metastasis
Lung
Therapeutics
X Ray Computed Tomography
X-Rays
Guidelines

Keywords

  • chest computerized tomography
  • indeterminate nodule
  • pulmonary metastasis
  • rectal cancer

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

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title = "Preoperative chest computerized tomography in patients with locally advanced mid or lower rectal cancer: Its role in staging and impact on treatment strategy",
abstract = "Objectives Pulmonary metastasis is frequent in rectal cancer. Some guidelines recommend chest computerized tomography (CT) for preoperative workup in rectal cancer patients, which have no solid evidence to support this recommendation. This study was designed to evaluate the role of chest CT on preoperative staging in rectal cancer patients and to assess the impact on treatment strategy. Methods Data were prospectively collected from 103 clinically T3/T4 mid or lower rectal cancer patients who had chest X-ray (CXR) and CT to evaluate lung metastasis. The chest images were classified into four groups: metastasis, indeterminate, benign, and negative. Patients showing indeterminate lesions had follow-up CTs at 3-to 6-month intervals. Results Nine patients (8.7{\%}) had pulmonary metastases detected on CT. CXR did not reveal any pulmonary metastatic lesions in four of the nine patients. Of these four, treatment was changed in three patients because of these findings. Forty (38.8{\%}) patients had indeterminate nodules on chest CT. Of these, 37 patients had follow-up CTs and four patients (10.8{\%}) showed interval changes that were confirmed as pulmonary metastasis. Conclusions It seems reasonable to perform chest CT for preoperative staging in patients with T3/T4 mid or lower rectal cancer.",
keywords = "chest computerized tomography, indeterminate nodule, pulmonary metastasis, rectal cancer",
author = "Choi, {Dong Jin} and Jung-Myun Kwak and Jin Kim and Woo, {Si Uk} and Kim, {Seon Hahn}",
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T1 - Preoperative chest computerized tomography in patients with locally advanced mid or lower rectal cancer

T2 - Its role in staging and impact on treatment strategy

AU - Choi, Dong Jin

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AU - Kim, Jin

AU - Woo, Si Uk

AU - Kim, Seon Hahn

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N2 - Objectives Pulmonary metastasis is frequent in rectal cancer. Some guidelines recommend chest computerized tomography (CT) for preoperative workup in rectal cancer patients, which have no solid evidence to support this recommendation. This study was designed to evaluate the role of chest CT on preoperative staging in rectal cancer patients and to assess the impact on treatment strategy. Methods Data were prospectively collected from 103 clinically T3/T4 mid or lower rectal cancer patients who had chest X-ray (CXR) and CT to evaluate lung metastasis. The chest images were classified into four groups: metastasis, indeterminate, benign, and negative. Patients showing indeterminate lesions had follow-up CTs at 3-to 6-month intervals. Results Nine patients (8.7%) had pulmonary metastases detected on CT. CXR did not reveal any pulmonary metastatic lesions in four of the nine patients. Of these four, treatment was changed in three patients because of these findings. Forty (38.8%) patients had indeterminate nodules on chest CT. Of these, 37 patients had follow-up CTs and four patients (10.8%) showed interval changes that were confirmed as pulmonary metastasis. Conclusions It seems reasonable to perform chest CT for preoperative staging in patients with T3/T4 mid or lower rectal cancer.

AB - Objectives Pulmonary metastasis is frequent in rectal cancer. Some guidelines recommend chest computerized tomography (CT) for preoperative workup in rectal cancer patients, which have no solid evidence to support this recommendation. This study was designed to evaluate the role of chest CT on preoperative staging in rectal cancer patients and to assess the impact on treatment strategy. Methods Data were prospectively collected from 103 clinically T3/T4 mid or lower rectal cancer patients who had chest X-ray (CXR) and CT to evaluate lung metastasis. The chest images were classified into four groups: metastasis, indeterminate, benign, and negative. Patients showing indeterminate lesions had follow-up CTs at 3-to 6-month intervals. Results Nine patients (8.7%) had pulmonary metastases detected on CT. CXR did not reveal any pulmonary metastatic lesions in four of the nine patients. Of these four, treatment was changed in three patients because of these findings. Forty (38.8%) patients had indeterminate nodules on chest CT. Of these, 37 patients had follow-up CTs and four patients (10.8%) showed interval changes that were confirmed as pulmonary metastasis. Conclusions It seems reasonable to perform chest CT for preoperative staging in patients with T3/T4 mid or lower rectal cancer.

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