Skip to main content

Advertisement

SpringerLink
Log in

CT for lymph node staging of Colon cancer: not only size but also location and number of lymph node count

  • Hollow Organ GI
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic accuracy of imaging features to predict lymph node status of colon cancer using CT.

Methods

This was a retrospective study from 2 tertiary hospitals in South Korea and Netherlands. 317 Colon cancer patients who underwent primary surgical treatment were included. Number of lymph nodes according to the anatomical location, size, cluster, degree of attenuation, shape, presence of internal heterogeneity and ill-defined margin of the lymph node were assessed and compared according to histological lymph node status.

Results

The largest short diameter of lymph node and presence of internal heterogeneity of lymph node showed significant association with malignant lymph node status (P < 0.001 and P = 0.041, respectively). The ROC curve analysis revealed AUC of 0.703 for the largest short diameter of lymph node (P < 0.001), and AUC of the presence of internal heterogeneity was 0.630 (P < 0.001). In addition, our study showed that a total number of lymph nodes, regardless of size, (P = 0.022) and number of lymph nodes in peritumoral area (P < 0.001) and along the mesenteric vessels (P < 0.001) on CT demonstrated significant association with malignant status of lymph nodes in colon cancer.

Conclusions

There were significant associations between lymph node status and imaging features of lymph nodes on CT in colon cancer patients. The largest short diameter of lymph node and presence of internal heterogeneity can be used to predict the malignant status of lymph node in colon cancer patients. Also, the number of lymph nodes near the colonic tumor should be considered in assessment of colon cancer lymph node involvement on CT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Binefa G, Rodriguez-Moranta F, Teule A, Medina-Hayas M (2014) Colorectal cancer: from prevention to personalized medicine. World J Gastroenterol 20 (22):6786-6808. doi:https://doi.org/10.3748/wjg.v20.i22.6786

    Article  PubMed  PubMed Central  Google Scholar 

  2. Tudyka V, Blomqvist L, Beets-Tan RG, Boelens PG, Valentini V, van de Velde CJ, Dieguez A, Brown G (2014) EURECCA consensus conference highlights about colon & rectal cancer multidisciplinary management: the radiology experts review. Eur J Surg Oncol 40 (4):469-475. doi:https://doi.org/10.1016/j.ejso.2013.10.029

    Article  CAS  PubMed  Google Scholar 

  3. Valentini V, Glimelius B, Haustermans K, Marijnen CA, Rodel C, Gambacorta MA, Boelens PG, Aristei C, van de Velde CJ (2014) EURECCA consensus conference highlights about rectal cancer clinical management: the radiation oncologist's expert review. Radiother Oncol 110 (1):195-198. doi:https://doi.org/10.1016/j.radonc.2013.10.024

    Article  PubMed  Google Scholar 

  4. Dighe S, Blake H, Koh MD, Swift I, Arnaout A, Temple L, Barbachano Y, Brown G (2010) Accuracy of multidetector computed tomography in identifying poor prognostic factors in colonic cancer. Br J Surg 97 (9):1407-1415. doi:https://doi.org/10.1002/bjs.7096

    Article  CAS  PubMed  Google Scholar 

  5. Stocchi L, Fazio VW, Lavery I, Hammel J (2011) Individual surgeon, pathologist, and other factors affecting lymph node harvest in stage II colon carcinoma. is a minimum of 12 examined lymph nodes sufficient? Ann Surg Oncol 18 (2):405–412. doi:https://doi.org/10.1245/s10434-010-1308-5

  6. Sjo OH, Merok MA, Svindland A, Nesbakken A (2012) Prognostic impact of lymph node harvest and lymph node ratio in patients with colon cancer. Dis Colon Rectum 55 (3):307-315. doi:https://doi.org/10.1097/DCR.0b013e3182423f62

    Article  PubMed  Google Scholar 

  7. Hunter C, Siddiqui M, Georgiou Delisle T, Blake H, Jeyadevan N, Abulafi M, Swift I, Toomey P, Brown G (2017) CT and 3-T MRI accurately identify T3c disease in colon cancer, which strongly predicts disease-free survival. Clin Radiol 72 (4):307-315. doi:https://doi.org/10.1016/j.crad.2016.11.014

    Article  CAS  PubMed  Google Scholar 

  8. Foxtrot Collaborative G (2012) Feasibility of preoperative chemotherapy for locally advanced, operable colon cancer: the pilot phase of a randomised controlled trial. Lancet Oncol 13 (11):1152-1160. doi:https://doi.org/10.1016/S1470-2045(12)70348-0

    Article  CAS  Google Scholar 

  9. Dighe S, Swift I, Magill L, Handley K, Gray R, Quirke P, Morton D, Seymour M, Warren B, Brown G (2012) Accuracy of radiological staging in identifying high-risk colon cancer patients suitable for neoadjuvant chemotherapy: a multicentre experience. Colorectal Dis 14 (4):438-444. doi:https://doi.org/10.1111/j.1463-1318.2011.02638.x

    Article  CAS  PubMed  Google Scholar 

  10. Nerad E, Lahaye MJ, Maas M, Nelemans P, Bakers FC, Beets GL, Beets-Tan RG (2016) Diagnostic Accuracy of CT for Local Staging of Colon Cancer: A Systematic Review and Meta-Analysis. AJR Am J Roentgenol 207 (5):984-995. doi:https://doi.org/10.2214/AJR.15.15785

    Article  PubMed  Google Scholar 

  11. Rollven E, Abraham-Nordling M, Holm T, Blomqvist L (2017) Assessment and diagnostic accuracy of lymph node status to predict stage III colon cancer using computed tomography. Cancer Imaging 17 (1):3. doi:https://doi.org/10.1186/s40644-016-0104-2

    Article  PubMed  PubMed Central  Google Scholar 

  12. Japanese Society for Cancer of the C, Rectum (2019) Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma: the 3d English Edition [Secondary Publication]. J Anus Rectum Colon 3 (4):175–195. doi:https://doi.org/10.23922/jarc.2019-018

  13. Kanamoto T, Matsuki M, Okuda J, Inada Y, Tatsugami F, Tanikake M, Yoshikawa S, Narabayashi I, Kawasaki H, Tanaka K, Yamamoto T, Tanigawa N, Egashira Y, Shibayama Y (2007) Preoperative evaluation of local invasion and metastatic lymph nodes of colorectal cancer and mesenteric vascular variations using multidetector-row computed tomography before laparoscopic surgery. J Comput Assist Tomogr 31 (6):831-839. doi:https://doi.org/10.1097/RCT.0b013e3180517af3

    Article  PubMed  Google Scholar 

  14. Rollven E, Blomqvist L, Oistamo E, Hjern F, Csanaky G, Abraham-Nordling M (2019) Morphological predictors for lymph node metastases on computed tomography in colon cancer. Abdom Radiol (NY) 44 (5):1712-1721. doi:https://doi.org/10.1007/s00261-019-01900-z

    Article  Google Scholar 

  15. Sibileau E, Ridereau-Zins C, Vanel D, Pavageau AH, Bertrais S, Metivier-Cesbron E, Venara A, Aube C (2014) Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study. Abdom Imaging 39 (5):941-948. doi:https://doi.org/10.1007/s00261-014-0150-9

    Article  CAS  PubMed  Google Scholar 

  16. Chen SL, Bilchik AJ (2006) More extensive nodal dissection improves survival for stages I to III of colon cancer: a population-based study. Ann Surg 244 (4):602-610. doi:https://doi.org/10.1097/01.sla.0000237655.11717.50

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chalabi M, Fanchi LF, Dijkstra KK, Van den Berg JG, Aalbers AG, Sikorska K, Lopez-Yurda M, Grootscholten C, Beets GL, Snaebjornsson P, Maas M, Mertz M, Veninga V, Bounova G, Broeks A, Beets-Tan RG, de Wijkerslooth TR, van Lent AU, Marsman HA, Nuijten E, Kok NF, Kuiper M, Verbeek WH, Kok M, Van Leerdam ME, Schumacher TN, Voest EE, Haanen JB (2020) Neoadjuvant immunotherapy leads to pathological responses in MMR-proficient and MMR-deficient early-stage colon cancers. Nat Med 26 (4):566-576. doi:https://doi.org/10.1038/s41591-020-0805-8

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands

    Eun Kyoung Hong, Federica Landolfi, Francesca Castagnoli, Judith Boot, Jose Van den Berg & Regina Beets-Tan

  2. GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands

    Eun Kyoung Hong & Regina Beets-Tan

  3. Radiology Unit, Sapienza University of Rome, Sant’Andrea Hospital, Rome, Italy

    Federica Landolfi

  4. Department of Radiology, University of Brescia, Brescia, Italy

    Francesca Castagnoli

  5. Seoul National University Hospital, Seoul, South Korea

    Eun Kyoung Hong, Sae Jin Park & Jeong Min Lee

  6. Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands

    Jose Van den Berg

Authors
  1. Eun Kyoung Hong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Federica Landolfi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Francesca Castagnoli
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sae Jin Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Judith Boot
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jose Van den Berg
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jeong Min Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Regina Beets-Tan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eun Kyoung Hong.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hong, E.K., Landolfi, F., Castagnoli, F. et al. CT for lymph node staging of Colon cancer: not only size but also location and number of lymph node count. Abdom Radiol 46, 4096–4105 (2021). https://doi.org/10.1007/s00261-021-03057-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-021-03057-0

Keywords

Search

Navigation