Annals of Coloproctology

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Corrigendum: Correction of the IRB Approval Number. Accuracy of Preoperative Local Staging of Primary Colorectal Cancer by Using Computed Tomography: Reappraisal Based on Data Collected at a Highly Organized Cancer Center: Jung Sub So, Chinock Cheong, Seung Yeop Oh, Jei Hee Lee, Young Bae Kim, Kwang Wook Suh; Ann Coloproctol. 2017;33(6):255-255. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.255

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Original Articles

Accuracy of Preoperative Local Staging of Primary Colorectal Cancer by Using Computed Tomography: Reappraisal Based on Data Collected at a Highly Organized Cancer Center: Jung Sub So, Chinock Cheong, Seung Yeop Oh, Jei Hee Lee, Young Bae Kim, Kwang Wook Suh; Ann Coloproctol. 2017;33(5):192-196. Published online October 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.5.192

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17 Citations

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Purpose

In patients with colorectal cancer, preoperative staging using various imaging technologies is important for establishing the treatment plan and predicting the prognosis. Although computed tomography (CT) has been used most widely, the versatility of CT accuracy was primarily because of the lack of specialization. In this study, we aimed to identify whether any advancement in abdominal CT accuracy in the prediction of local staging has occurred.

Methods

Between December 2014 and November 2015, patients with colorectal cancer were retrospectively enrolled. All CT findings were retrospectively reported. A total of 285 patients were included, and their retrospectively collected data were retrospectively reviewed, focusing on a comparison between preoperative and postoperative staging.

Results

The overall prediction accuracy of the T stage was 55.1%, with overstaging occurring in 63 (22.1%) and understaging in 65 patients (22.8%). The sensitivity and specificity were 90.0% and 68.4%, respectively. The overall prediction accuracy of the N stage was 54.7%, with overstaging occurring in 89 (31.2%) and understaging in 40 patients (14.1%). The sensitivity and specificity were 71.9% and 63.2%, respectively. The CT accuracies by pathologic stage were 0%, 62.2%, 25.3%, and 81.2% for stages 0 (Tis N0), I, II, and III, respectively.

Conclusion

CT has good sensitivity for detecting colon cancers with tumor invasion beyond the bowel wall. However, detection of nodal involvement using CT is unreliable. In our opinion, abdominal CT alone has limitations in predicting the local staging of colorectal cancer, and additional technologies, such as CT plus positron emission tomography and/or colonography, will improve its accuracy.

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Preoperative Localization of Early Colorectal Cancer or a Malignant Polyp by Using the Patient's Own Blood: Seung Hwan Lee, Do Yoon Kim, Seung Yeop Oh, Kwang Jae Lee, Kwang Wook Suh; Ann Coloproctol. 2014;30(3):115-117. Published online June 23, 2014; DOI: https://doi.org/10.3393/ac.2014.30.3.115

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51 Download
10 Web of Science
14 Citations

Abstract PDF

Purpose

Preoperative localization is the most important preparation for laparoscopic surgery. Preoperative marking with India ink has widely been used and is considered to be safe and effective. However, India ink can cause significant inflammation, adhesions and bowel obstruction. Therefore, we have used the patient's blood instead of the ink since 2011. In this retrospective study, we wanted to examine the feasibility of preoperative localization by using the patient's blood.

Methods

Twenty-five patients who underwent preoperative localization in which 10 mL of their own venous blood was used as a tattooing agent were included in this study. The characteristics of the patients, the anatomy of the colon cancer, and the efficacy and the side effects of using this procedure were analyzed.

Results

In 23 cases (92%), through the laparoscope, we found perfectly localized bloody smudges in the serosa. However, in 2 cases (8%), we could not find the exact location of the lesion. No patients showed any complications.

Conclusion

Preoperative localization of early colon cancer or a malignant polyp by using patient's blood is feasible, safe and simple. We think that using the patient's blood for localization of a lesion is better than using some other foreign material such as India ink.

Citations

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