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Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and objective

Neoadjuvant therapy could improve oncological outcome of patients suffering from colon cancer. An accurate staging method is needed to define suitable patients. The aim of this retrospective study was to validate the value of CT for identifying patients with local advanced (T3/4) or nodal-positive colon cancer.

Methods and material

Preoperative abdominal CT scans of 210 patients with colon cancer were evaluated by two radiologists independently for the T stage and N stage. Results were compared to pathology. Patients were stratified according to the guidelines for rectal cancer into patients with low risk (T0/1/2 and N0) or high risk (T3/4 or N+).

Results

Inter-observer correlation was high with over 90 %. Overall sensitivity T stage was 93.0 % and for N stage 76.9 %. Using CT scan to identify local advanced (T3/4 or N+) tumors, the consensus sensitivity was 94.9 %, the specificity 53.6 %, the positive predictive value (PPV) 92.8 %, and the negative predictive value (NPV) 62.5 %.

Conclusion

Computer tomography represents an effective tool for identifying patients with colon cancer suitable for neoadjuvant therapy according to the guidelines for rectal cancer.

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Acknowledgments

This publication was funded by the German Research Foundation (DFG), and the University of Würzburg is in the funding program “Open Access Publishing.”

The authors thank Miss L Stevensons for proofreading the manuscript.

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Authors and Affiliations

  1. Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany

    Armin Wiegering, Ingo Klein, Ulrich A. Dietz, Christian Jurowich & Christoph-Thomas Germer

  2. Department of Biochemistry and Molecular Biology, Theodor-Boveri-Institute, Biocenter, University of Wuerzburg, 97070, Wuerzburg, Germany

    Armin Wiegering & Friedrich Wilhelm Uthe

  3. Department of Bioinformatics, Biocenter, University of Wuerzburg, Am Hubland, 97074, Wuerzburg, Germany

    Meik Kunz & Thomas Dandekar

  4. Department of Diagnostic and Interventional Radiology, University of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany

    Mohamed Hussein, Thorsten Bley & Christian Ritter

  5. Department of Pediatrics, University of Wuerzburg, Josef-Schneiderstr. 2, 97080, Wuerzburg, Germany

    Verena Wiegering

  6. Institute for Diagnostic and Interventional Radiology, Georg-August-University Göttingen, UMG Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37099, Göttingen, Germany

    Christian Ritter

Authors
  1. Armin Wiegering
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  2. Meik Kunz
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  3. Mohamed Hussein
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  4. Ingo Klein
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  5. Verena Wiegering
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  6. Friedrich Wilhelm Uthe
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  7. Ulrich A. Dietz
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  8. Christian Jurowich
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  9. Thorsten Bley
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  10. Thomas Dandekar
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  11. Christoph-Thomas Germer
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  12. Christian Ritter
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Corresponding author

Correspondence to Armin Wiegering.

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Wiegering, A., Kunz, M., Hussein, M. et al. Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy. Int J Colorectal Dis 30, 1067–1073 (2015). https://doi.org/10.1007/s00384-015-2265-z

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  • DOI: https://doi.org/10.1007/s00384-015-2265-z

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