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Clinical Implications of Lymph Node Metastasis in Colorectal Cancer: Current Status and Future Perspectives
Hye Jin Kim, Gyu–Seog Choi
Ann Coloproctol. 2019;35(3):109-117.   Published online June 30, 2019
DOI: https://doi.org/10.3393/ac.2019.06.12
  • 22,970 View
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  • 61 Web of Science
  • 60 Citations
AbstractAbstract PDF
Lymph node metastasis is regarded as an indubitable prognostic factor for predicting disease recurrence and survival in patients with colorectal cancer. Lymph node status based on examination of a resected specimen is a key element of the current staging system and is also a crucial factor to determine use of adjuvant chemotherapy after surgical resection. However, the current tumor-node-metastasis (TNM) staging system only incorporates the number of metastatic lymph nodes in the N category. Numerous attempts have been made to supplement this simplified N staging including lymph node ratio, distribution of metastatic lymph nodes, tumor deposits, or extracapsular invasion. In addition, several attempts have been made to identify more specific prognostic factors in resected colorectal specimens than lymph node status. In this review, we will discuss controversies in lymph node staging and factors that may influence survival beyond lymph node status.

Citations

Citations to this article as recorded by  
  • Role of Adjuvant Chemotherapy After Surgical Resection of Paraaortic Lymph Node Metastasis from Colorectal Cancer—A Multicenter Retrospective Study
    Hiroaki Nozawa, Sono Ito, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Shinichi Yamauchi, Yusuke Kinugasa, Yoichi Ajioka, Soichiro Ishihara
    Annals of Surgical Oncology.2025; 32(4): 2282.     CrossRef
  • Lighthouses illuminating tumor metastasis: The application of fluorescent probes in the localization and imaging metastatic lymph nodes across various tumors
    Qi Dang, Linhao Zhang, Huipeng Ma, Xiaoshan Sun, Anguo Ren, Jiuyang Chen, Xiaohua Huang, Boyu Zhang, Wen Sun
    Biomaterials.2025; 316: 123020.     CrossRef
  • Lymph node yield does not affect the cancer-specific survival of patients with T1 colorectal cancer: a population-based retrospective study of the U.S. database and a Chinese registry
    Jiyun Li, Ruoxi Tian, Fei Huang, Pu Cheng, Fuqiang Zhao, Zhixun Zhao, Qian Liu, Zhaoxu Zheng
    International Journal of Colorectal Disease.2025;[Epub]     CrossRef
  • Long‐Term Outcomes of Sigmoid, Rectosigmoid, and Rectal Cancers: A Matched Analysis
    Cigdem Benlice, Atilla Halil Elhan, Emre Gorgun, Mehmet Ayhan Kuzu
    World Journal of Surgery.2025; 49(4): 819.     CrossRef
  • The Value of Spectroscopic CT for Lymph Node Metastasis in Rectal Cancer
    冬冬 穆
    Journal of Clinical Personalized Medicine.2025; 04(01): 501.     CrossRef
  • A novel pN stage prediction model for resectable rectal adenocarcinoma based on preoperative MRI features and multiregional apparent diffusion coefficients
    Hui Luo, Yue-qin Gou, Yue-su Wang, Hui-lin Qin, Hai-ying Zhou, Xiao-ming Zhang, Tian-wu Chen
    European Radiology.2025; 35(9): 5760.     CrossRef
  • Indocyanine Green Near-Infrared Fluorescence-Guided Sentinel Lymph Node Biopsy in Colon Cancer
    Vlad Fagarasan, Vasile V. Bintintan, Radu I. Seicean, Giorgiana Fagarasan, David Andras, Emil Botan, Gabriel Samasca, George C. Dindelegan, Calin I. Cainap
    Biomedicines.2025; 13(4): 902.     CrossRef
  • Performance and Prognostic Relevance of Lymph Node Assessment by One-Step Nucleic Acid Amplification Assay in Rectal Cancer: A Multicenter Study
    Qing Liu, Sandra Lopez-Prades, Karmele Saez de Gordoa, Maite Rodrigo-Calvo, Mireia Garcia, Juan Ruiz Martin, Angel Romo, Ignacio Pinilla, Jordi Tarragona, Begoña Otero Alen, Jordi Camps, Ivan Archilla, Miriam Cuatrecasas
    Cancers.2025; 17(13): 2141.     CrossRef
  • Prognostic value of metastatic lymph node ratio and its effect on disease-free survival in colon cancer
    Orhan Aslan, Ramazan Topcu, İsmail Sezikli, Mahmut A. Yüksek, Aşkın K. Perçem, Furkan Uğur
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • B7-H3: a consistent marker in metastatic colorectal cancer with potential for targeted treatment
    Julia M. Ott, Verena Gassenmaier, Michael Bitzer, Christian M. Schürch, Jonas S. Heitmann, Ilona Hagelstein
    Pathology and Oncology Research.2025;[Epub]     CrossRef
  • The application of random forest-based models in prognostication of gastrointestinal tract malignancies: a systematic review
    Zhina Mohamadi, Ahmad Shafizadeh, Yasaman Aliyan, Seyedeh Fatemeh Shayesteh, Parsa Goudarzi, Alireza Khodabandeh, Amirali Vaghari, Helma Ashrafi, Omid Bahrami, Armin ZarinKhat, Yalda Khodabandeh, Kimia Pouyan
    Frontiers in Artificial Intelligence.2025;[Epub]     CrossRef
  • Mutation profiling of KRAS and BRAF in primary tumours and circulating tumour cells of colorectal cancer patients using PNA-LNA molecular switch
    Md Sajedul Islam, Eliza Ranjit, Sharmin Aktar, Neda Moetamedirad, Cu Tai Lu, Muhammad J.A. Shiddiky, Vinod Gopalan, Alfred K. Lam
    Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease.2025; 1871(7): 167982.     CrossRef
  • Utilizing tumor deposit count as a stratification criterion in revising TNM staging system for patients with colorectal cancer: a nomogram review study
    Lifei Zhang, Yunna Ma, Jiantao Dong, Jianhui Cai
    Frontiers in Oncology.2025;[Epub]     CrossRef
  • An Uncharted Path of Metastasis: A Case Report of Sigmoid Colon Cancer with Synchronous Vaginal and Urethral Spread
    John Fernando Montenegro, Giovanna Patricia Rivas Tafur, Miguel Diaz, Diego Fernando Alzate, María Camila Faria, Daniel Florez, Richard Andrés Acuña, Cesar Eduardo, Yamil Liscano
    Diseases.2025; 13(8): 251.     CrossRef
  • Construction of a risk prediction model for early postoperative recurrence in stage II/III colorectal cancer
    Feng-Chun Xiong, Ming-Peng Luo, Shan-Ming Ruan
    World Journal of Gastrointestinal Oncology.2025;[Epub]     CrossRef
  • Peritoneal Lavage Cytology Predicts Peritoneal Metastasis and is Associated with Poor Prognosis in Patients with Stage II–III Colorectal Cancer
    Dewei Kong, Yingjie Li, Shenyi Yin, Yunfei Tan, Boyang Qu, Lei Huang, Jianzhong Jeff Xi, Aiwen Wu
    Annals of Surgical Oncology.2025;[Epub]     CrossRef
  • TRAIL‐conjugated liposomes that bind natural killer cells to induce colorectal cancer cell apoptosis
    Joshua D. Greenlee, Zhenjiang Zhang, Tejas Subramanian, Kevin Liu, Michael R. King
    Journal of Biomedical Materials Research Part A.2024; 112(1): 110.     CrossRef
  • Lymph Node Ratio as a Predictor of Survival for Colon Cancer: A Systematic Review and Meta-Analysis
    Simarpreet Ichhpuniani, Tyler McKechnie, Jay Lee, Jeremy Biro, Yung Lee, Lily Park, Aristithes Doumouras, Dennis Hong, Cagla Eskicioglu
    The American Surgeon™.2024; 90(4): 840.     CrossRef
  • Acetone compression improves lymph node yield and metastasis detection in colorectal cancer
    Christina Schnoz, Katrin Schmid, Guacimara Ortega Sanchez, Sabina Schacher-Kaufmann, Michel Adamina, Georgios Peros, Dieter Erdin, Peter Karl Bode
    Clinical & Experimental Metastasis.2024; 41(1): 45.     CrossRef
  • Computational methods for metastasis detection in lymph nodes and characterization of the metastasis-free lymph node microarchitecture: A systematic-narrative hybrid review
    Elzbieta Budginaite, Derek R. Magee, Maximilian Kloft, Henry C. Woodruff, Heike I. Grabsch
    Journal of Pathology Informatics.2024; 15: 100367.     CrossRef
  • Sequential Lateral Lymphatic Metastasis Shows Similar Oncologic Outcomes to Upward Spread in Advanced Rectal Cancer After Preoperative Chemoradiotherapy
    Hye Jin Kim, Gyu-Seog Choi, Seung Hyun Cho, Min Kyu Kang, Jun Seok Park, Soo Yeun Park, Byung Woog Kang, Jong Gwang Kim
    Diseases of the Colon & Rectum.2024; 67(3): 359.     CrossRef
  • The Evolving Role of Artificial Intelligence in Gastrointestinal Histopathology: An Update
    D. Chamil Codipilly, Shahriar Faghani, Catherine Hagan, Jason Lewis, Bradley J. Erickson, Prasad G. Iyer
    Clinical Gastroenterology and Hepatology.2024; 22(6): 1170.     CrossRef
  • INFLUENCE OF NEOADJUVANT THERAPY ON THE RATIO OF LYMPH NODES
    Laura CREDIDIO, Carlos Augusto Real MARTINEZ, Daniéla Oliveira MAGRO, Rita Barbosa de CARVALHO, Maria de Lourdes Setsuko AYRIZONO, Cláudio Saddy Rodrigues COY
    Arquivos de Gastroenterologia.2024;[Epub]     CrossRef
  • National screening for colorectal cancer is associated with stage shift to earlier diagnosis
    Mina Sarofim, Amir Ashrafizadeh, Anthony J. Gill, Keshani de Silva, Justin Evans, Stephen Clarke, Nick Pavlakis, Ian Norton, Alexander Engel
    ANZ Journal of Surgery.2024; 94(7-8): 1279.     CrossRef
  • Competing‐risks model for predicting the prognosis of patients with regressive melanoma based on the SEER database
    Chaodi Huang, Liying Huang, Jianguo Huang, Xinkai Zheng, Congjun Jiang, Kong Ching Tom, U. Tim Wu, WenHsien Ethan Huang, Yunfei Gao, Fangmin Situ, Hai Yu, Liehua Deng, Jun Lyu
    Malignancy Spectrum.2024; 1(2): 123.     CrossRef
  • The Relationship between Tumor Budding and Tumor Deposits in Patients with Stage III Colorectal Carcinoma
    Zdenko Bilić, Mario Zovak, Goran Glavčić, Dubravka Mužina, Amir Ibukić, Andro Košec, Davor Tomas, Alma Demirović
    Journal of Clinical Medicine.2024; 13(9): 2583.     CrossRef
  • Standardizing data collection in adjuvant colon cancer trials: A consensus project from the IDEA and ACCENT international consortia and national experts
    Julien Taieb, Debora Basile, Jenny Seligmann, Guillem Argiles, Thierry André, Claire Gallois, Richard M. Goldberg, Greg Yothers, Alberto Sobrero, Jeffrey A. Meyerhardt, John Souglakos, Roberto Labianca, Tim Iveson, David N. Church, Dirk Arnold, Jeanne Tie
    European Journal of Cancer.2024; 206: 114118.     CrossRef
  • GLI1 and PTTG1 expression in colorectal carcinoma patients undergoing radical surgery and their correlation with lymph node metastasis
    Feng Cao, Yang-Yan Chen, Hong-Cheng Wang
    World Journal of Gastrointestinal Surgery.2024; 16(5): 1328.     CrossRef
  • Application of radiomics for preoperative prediction of lymph node metastasis in colorectal cancer: a systematic review and meta-analysis
    Elahe Abbaspour, Sahand Karimzadhagh, Abbas Monsef, Farahnaz Joukar, Fariborz Mansour-Ghanaei, Soheil Hassanipour
    International Journal of Surgery.2024; 110(6): 3795.     CrossRef
  • A pathologist–AI collaboration framework for enhancing diagnostic accuracies and efficiencies
    Zhi Huang, Eric Yang, Jeanne Shen, Dita Gratzinger, Frederick Eyerer, Brooke Liang, Jeffrey Nirschl, David Bingham, Alex M. Dussaq, Christian Kunder, Rebecca Rojansky, Aubre Gilbert, Alexandra L. Chang-Graham, Brooke E. Howitt, Ying Liu, Emily E. Ryan, Tr
    Nature Biomedical Engineering.2024; 9(4): 455.     CrossRef
  • OPTIMIZATION OF THE DIAGNOSIS OF LYMPH NODE METASTASIS IN PATIENTS WITH COLORECTAL CANCER USING RADIOLOGICAL IMAGING METHODS
    S.V. Maliborska, V.V. Holotiuk
    Art of Medicine.2024; : 63.     CrossRef
  • Low muscle mass-to-fat ratio is an independent factor that predicts worse overall survival and complications in patients with colon cancer: a retrospective single-center cohort study
    Jiabao Tang, Jingwen Xu, Xiaohua Li, Chun Cao
    Annals of Surgical Treatment and Research.2024; 107(2): 68.     CrossRef
  • Biomarkers of lymph node metastasis in colorectal cancer: update
    Xiao Zhu, Shui-quan Lin, Jun Xie, Li-hui Wang, Li-juan Zhang, Ling-ling Xu, Jian-guang Xu, Yang-bo Lv
    Frontiers in Oncology.2024;[Epub]     CrossRef
  • SURGICAL TREATMENT OF RECTAL CANCER WITH PRESERVATION OF THE LEFT COLIC ARTERY AND ICG NAVIGATION
    S.V. Maliborska
    Art of Medicine.2024; : 86.     CrossRef
  • Assessing the clinical utility of tumor invasion proportion of lymph nodes for enhanced risk stratification in N1 colorectal cancer
    Ru-Jie Chen
    American Journal of Cancer Research.2024; 14(12): 5826.     CrossRef
  • Survival outcomes after synchronous para‐aortic lymph node metastasis in colorectal cancer: A systematic review
    Conor Aylward, Jawed Noori, Jack Tyrrell, Niall O'sullivan, Dara O. Kavanagh, John O. Larkin, Brian J. Mehigan, Paul H. McCormick, Michael E. Kelly
    Journal of Surgical Oncology.2023; 127(4): 645.     CrossRef
  • National assessment of lymph node status indicators & predictors in pediatric head and neck rhabdomyosarcomas in the US
    David J. Fei-Zhang, Asher C. Park, Joseph M. Berry, Rebecca S. Arch, Daniel C. Chelius, Anthony M. Sheyn, Jeffrey C. Rastatter
    International Journal of Pediatric Otorhinolaryngology.2023; 164: 111419.     CrossRef
  • Increased Kremen2 predicts worse prognosis in colon cancer
    Junxian Long, Fengyun Cong, Yousheng Wei, Jungang Liu, Weizhong Tang
    Pathology and Oncology Research.2023;[Epub]     CrossRef
  • Predictors and survival outcomes of having less than 12 harvested lymph nodes in proctectomy for rectal cancer
    Sameh Hany Emile, Nir Horesh, Zoe Garoufalia, Rachel Gefen, Peige Zhou, Steven D. Wexner
    International Journal of Colorectal Disease.2023;[Epub]     CrossRef
  • Lymph node metastasis in cancer progression: molecular mechanisms, clinical significance and therapeutic interventions
    Haoran Ji, Chuang Hu, Xuhui Yang, Yuanhao Liu, Guangyu Ji, Shengfang Ge, Xiansong Wang, Mingsong Wang
    Signal Transduction and Targeted Therapy.2023;[Epub]     CrossRef
  • The Role of Nonmetastatic Lymph Nodes in the Survival of Colorectal Cancer: A Systematic Review
    Alexander J. Pennings, Brecht A. van der Velden, Maximilian Kloft, Loes F. S. Kooreman, Jos M. P. Kleijnen, Stephanie O. Breukink, Geerard L. Beets, Heike I. Grabsch, Jarno Melenhorst
    Annals of Surgery Open.2023; 4(4): e336.     CrossRef
  • Multicenter study of prognostic factors in paraaortic lymph node dissection for metastatic colorectal cancer
    Jun Woo Bong, Sanghee Kang, Pyoungjae Park
    Annals of Surgical Treatment and Research.2023; 105(5): 271.     CrossRef
  • Long-Term Outcomes of Surgical Resection of Pathologically Confirmed Isolated Para-Aortic Lymph Node Metastases in Colorectal Cancer: A Systematic Review
    Maurizio Zizzo, Maria Pia Federica Dorma, Magda Zanelli, Francesca Sanguedolce, Maria Chiara Bassi, Andrea Palicelli, Stefano Ascani, Alessandro Giunta
    Cancers.2022; 14(3): 661.     CrossRef
  • Risk factors for long-term survival in patients with ypN+ M0 rectal cancer after radical anterior resection
    Marcin Zeman, Władysław Skałba, Piotr Szymański, Grzegorz Hadasik, Dmytro Żaworonkow, Dominik A. Walczak, Agnieszka Czarniecka
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Watch and wait strategies for rectal cancer: A systematic review
    In Ja Park
    Precision and Future Medicine.2022; 6(2): 91.     CrossRef
  • An unusual case of right-sided colon cancer with isolated lateral pelvic side wall lymph node metastases
    Rishaan Pawaskar, James Wei Tatt Toh
    Laparoscopic, Endoscopic and Robotic Surgery.2022; 5(3): 121.     CrossRef
  • High-resolution MRI-based radiomics analysis to predict lymph node metastasis and tumor deposits respectively in rectal cancer
    Yan-song Yang, Feng Feng, Yong-juan Qiu, Gui-hua Zheng, Ya-qiong Ge, Yue-tao Wang
    Abdominal Radiology.2021; 46(3): 873.     CrossRef
  • Extricating the Association Between the Prognostic Factors of Colorectal Cancer
    Younis Mohd, Balamuralikrishnan Balasubramanian, Arun Meyyazhagan, Haripriya Kuchi Bhotla, Suresh Kumar Shanmugam, Mithun Kumar Ramesh Kumar, Manikantan Pappusamy, Karthick Kumar Alagamuthu, Sasikala Keshavarao, Vijaya Anand Arumugam
    Journal of Gastrointestinal Cancer.2021; 52(3): 1022.     CrossRef
  • Retrospective survival analysis of stage II–III rectal cancer: tumour regression grade, grading and lymphovascular invasion are the only predictors
    Andrea Morini, Alfredo Annicchiarico, Andrea Romboli, Matteo Ricco', Pellegrino Crafa, Filippo Montali, Paolo Dell'Abate, Renato Costi
    ANZ Journal of Surgery.2021;[Epub]     CrossRef
  • Competitive Risk Analysis of Prognosis in Patients With Cecum Cancer: A Population-Based Study
    Wentao Wu, Jin Yang, Daning Li, Qiao Huang, Fanfan Zhao, Xiaojie Feng, Hong Yan, Jun Lyu
    Cancer Control.2021;[Epub]     CrossRef
  • Increased Expression of VANGL1 is Predictive of Lymph Node Metastasis in Colorectal Cancer: Results from a 20-Gene Expression Signature
    Noshad Peyravian, Stefania Nobili, Zahra Pezeshkian, Meysam Olfatifar, Afshin Moradi, Kaveh Baghaei, Fakhrosadat Anaraki, Kimia Nazari, Hamid Asadzadeh Aghdaei, Mohammad Reza Zali, Enrico Mini, Ehsan Nazemalhosseini Mojarad
    Journal of Personalized Medicine.2021; 11(2): 126.     CrossRef
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    Mizelle D’Silva, Jai Young Cho, Ho-Seong Han, Taupyk Yerlan, Yoo-Seok Yoon, Hae Won Lee, Jun Suh Lee, Boram Lee, Moonhwan Kim
    Scientific Reports.2021;[Epub]     CrossRef
  • Optimal Postoperative Surveillance Strategies for Colorectal Cancer: A Retrospective Observational Study
    Min-Young Park, In-Ja Park, Hyo-Seon Ryu, Jay Jung, Min-Sung Kim, Seok-Byung Lim, Chang-Sik Yu, Jin-Cheon Kim
    Cancers.2021; 13(14): 3502.     CrossRef
  • Outcomes of Level of Ligation of Inferior Mesenteric Artery in Colorectal Cancer: a Systematic Review and Meta-Analysis
    Pavan Kumar Jonnada, Monish Karunakaran, Dayakar Rao
    Future Oncology.2021; 17(27): 3645.     CrossRef
  • Gastrointestinal cancer classification and prognostication from histology using deep learning: Systematic review
    Sara Kuntz, Eva Krieghoff-Henning, Jakob N. Kather, Tanja Jutzi, Julia Höhn, Lennard Kiehl, Achim Hekler, Elizabeth Alwers, Christof von Kalle, Stefan Fröhling, Jochen S. Utikal, Hermann Brenner, Michael Hoffmeister, Titus J. Brinker
    European Journal of Cancer.2021; 155: 200.     CrossRef
  • One-Step Nucleic Acid Amplification (OSNA) of Sentinel Lymph Node in Early-Stage Endometrial Cancer: Spanish Multicenter Study (ENDO-OSNA)
    María Diestro, Alberto Berjón, Ignacio Zapardiel, Laura Yébenes, Irune Ruiz, Arantza Lekuona, Marta Rezola, Ibon Jaunarena, Jaime Siegrist, Margarita Sánchez-Pastor, María Cuadra, Amaia Sagasta, Isabel Guerra, Luis Lete, Fernando Roldán, Carlo Marta, Marí
    Cancers.2021; 13(17): 4465.     CrossRef
  • Deep learning can predict lymph node status directly from histology in colorectal cancer
    Lennard Kiehl, Sara Kuntz, Julia Höhn, Tanja Jutzi, Eva Krieghoff-Henning, Jakob N. Kather, Tim Holland-Letz, Annette Kopp-Schneider, Jenny Chang-Claude, Alexander Brobeil, Christof von Kalle, Stefan Fröhling, Elizabeth Alwers, Hermann Brenner, Michael Ho
    European Journal of Cancer.2021; 157: 464.     CrossRef
  • Pathological Features and Prognostication in Colorectal Cancer
    Kabytto Chen, Geoffrey Collins, Henry Wang, James Wei Tatt Toh
    Current Oncology.2021; 28(6): 5356.     CrossRef
  • Distant Metastasis in Colorectal Cancer Patients—Do We Have New Predicting Clinicopathological and Molecular Biomarkers? A Comprehensive Review
    Stanislav Filip, Veronika Vymetalkova, Jiri Petera, Ludmila Vodickova, Ondrej Kubecek, Stanislav John, Filip Cecka, Marketa Krupova, Monika Manethova, Klara Cervena, Pavel Vodicka
    International Journal of Molecular Sciences.2020; 21(15): 5255.     CrossRef
  • Small Molecules for Multi-Wavelength Near-Infrared Fluorescent Mapping of Regional and Sentinel Lymph Nodes in Colorectal Cancer Staging
    Victor M. Baart, Marion M. Deken, Mark W. Bordo, Shadhvi S. Bhairosingh, Daniela C. F. Salvatori, Hoon Hyun, Maged Henary, Hak Soo Choi, Cornelis F. M. Sier, Peter J. K. Kuppen, Anton G. T. Terwisscha van Scheltinga, Taryn L. March, Adrianus R. P. M. Vale
    Frontiers in Oncology.2020;[Epub]     CrossRef
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
  • 7,874 View
  • 115 Download
  • 19 Web of Science
  • 17 Citations
AbstractAbstract PDF
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.

Citations

Citations to this article as recorded by  
  • Optimal extent of lymph node dissection in clinical early-stage right colon cancer: a retrospective analysis
    Hyeung-min Park, Jaram Lee, Soo Young Lee, Suk Hee Heo, Yong Yeon Jeong, Hyeong Rok Kim, Chang Hyun Kim
    Annals of Surgical Treatment and Research.2025; 108(1): 49.     CrossRef
  • A 14‐Gene Panel for Predicting Colorectal Cancer Recurrence Using Circulating Tumor DNA in Different Testing Conditions
    Yuichi Hisamatsu, Koji Ando, Kensuke Kudo, Ryota Nakanishi, Tetsuro Kawazoe, Yoko Zaitsu, Tetsuya Kusumoto, Taishi Hata, Yoshinori Kagawa, Tomoharu Yoshizumi, Naoko Ashida, Hayato Niiro, Takashi Hirose, Eiji Oki
    Cancer Science.2025; 116(9): 2499.     CrossRef
  • Stenting as bridge to surgery versus upfront emergency resection for non-metastatic left sided obstructing colorectal cancer: risk of peritoneal recurrence and long-term outcomes
    Wenjie Lin, Aik Yong Chok, Isaac Seow-En, Emile Kwong-Wei Tan
    Surgical Endoscopy.2024; 38(5): 2632.     CrossRef
  • The impact of myosteatosis on outcomes following surgery for gastrointestinal malignancy: a meta-analysis
    A MacCormick, A Streeter, M Puckett, S Aroori
    The Annals of The Royal College of Surgeons of England.2023; 105(3): 203.     CrossRef
  • Intelligent diagnosis value of preoperative T staging of colorectal cancer based on MR medical imaging
    Junqing Wang, Bingqian Chen, Jing Zhu, Junfeng Zhang, Rui Jiang
    Frontiers in Genetics.2023;[Epub]     CrossRef
  • Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
    Ji-Hyun Seo, In-Ja Park
    Cancers.2023; 15(21): 5211.     CrossRef
  • Imaging of Colorectal Liver Metastasis
    Azarakhsh Baghdadi, Sahar Mirpour, Maryam Ghadimi, Mina Motaghi, Bita Hazhirkarzar, Timothy M. Pawlik, Ihab R. Kamel
    Journal of Gastrointestinal Surgery.2022; 26(1): 245.     CrossRef
  • The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

    Colorectal Disease.2022; 24(6): 708.     CrossRef
  • The Mesentery in Complete Mesocolic Excision
    Jordan Fletcher, Danilo Miskovic
    Clinics in Colon and Rectal Surgery.2022; 35(04): 288.     CrossRef
  • Long-term outcomes of D2 vs. D3 lymph node dissection for cT2N0M0 colorectal cancer: a multi‑institutional retrospective analysis
    Tadahiro Kojima, Hitoshi Hino, Akio Shiomi, Hiroyasu Kagawa, Yusuke Yamaoka, Shoichi Manabe, Kai Chen, Kenji Nanishi, Shinichi Yamauchi, Kenichi Sugihara
    International Journal of Clinical Oncology.2022; 27(11): 1717.     CrossRef
  • Colon cancer CT staging according to mismatch repair status: Comparison and suggestion of imaging features for high-risk colon cancer
    Eun Kyoung Hong, Myriam Chalabi, Federica Landolfi, Francesca Castagnoli, Sae Jin Park, Karolina Sikorska, Arend Aalbers, Jose van den Berg, Monique van Leerdam, Jeong Min Lee, Regina Beets-Tan
    European Journal of Cancer.2022; 174: 165.     CrossRef
  • Accuracy of preoperative staging with multidetector computed tomography in colon cancer
    Anna Sofie Friis Olsen, Anders Kierkegaard Gundestrup, Jakob Kleif, Tara Thanon, Claus Anders Bertelsen
    Colorectal Disease.2021; 23(3): 680.     CrossRef
  • Clinical TNM staging for esophageal, gastric, and colorectal cancers in the era of neoadjuvant therapy: A systematic review of the literature
    Hideaki Shimada, Takeo Fukagawa, Yoshio Haga, Shin‐ichi Okazumi, Koji Oba
    Annals of Gastroenterological Surgery.2021; 5(4): 404.     CrossRef
  • Impact of D3 lymph node dissection on upstaging and short-term survival in clinical stage I right-sided colon cancer
    Ji-Seon Kim, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim, Woong Bae Ji, Jung Sik Kim, Kwang Dae Hong, Jun Won Um, Sang Hee Kang, Sun Il Lee, Byung Wook Min
    Asian Journal of Surgery.2021; 44(10): 1278.     CrossRef
  • The risk of nodal disease in patients with pathological complete responses after neoadjuvant chemoradiation for rectal cancer: a systematic review, meta-analysis, and meta-regression
    Ian Jun Yan Wee, Hai Man Cao, James Chi-Yong Ngu
    International Journal of Colorectal Disease.2019; 34(8): 1349.     CrossRef
  • Bildgebung vor kolorektaler Chirurgie aus Sicht des Chirurgen
    I. Iesalnieks, A. Agha
    Der Radiologe.2019; 59(9): 786.     CrossRef
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Individualized Cutoff Value of the Preoperative Carcinoembryonic Antigen Level is Necessary for Optimal Use as a Prognostic Marker
Byeong Geon Jeon, Rumi Shin, Jung Kee Chung, In Mok Jung, Seung Chul Heo
Ann Coloproctol. 2013;29(3):106-114.   Published online June 30, 2013
DOI: https://doi.org/10.3393/ac.2013.29.3.106
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AbstractAbstract PDF
Purpose

Carcinoembryonic antigen (CEA) is an important prognostic marker in colorectal cancer (CRC). However, in some stages, it does not work. We performed this study to find a way in which preoperative CEA could be used as a constant prognostic marker in harmony with the TNM staging system.

Methods

Preoperative CEA levels and recurrences in CRC were surveyed. The distribution of CEA levels and the recurrences in each TNM stage of CRC were analyzed. An optimal cutoff value for each TNM stage was calculated and tested for validity as a prognostic marker within the TNM staging system.

Results

The conventional cutoff value of CEA (5 ng/mL) was an independent prognostic factor on the whole. However, when evaluated in subgroups, it was not a prognostic factor in stage I or stage III of N2. A subgroup analysis according to TNM stage revealed different CEA distributions and recurrence rates corresponding to different CEA ranges. The mean CEA levels were higher in advanced stages. In addition, the recurrence rates of corresponding CEA ranges were higher in advanced stages. Optimal cutoff values from the receiver operating characteristic curves were 7.4, 5.5, and 4.5 ng/mL for TNM stage I, II, and III, respectively. Those for N0, N1, and N2 stages were 5.5, 4.8, and 3.5 ng/mL, respectively. The 5-year disease-free survivals were significantly different according to these cutoff values for each TNM and N stage. The multivariate analysis confirmed the new cutoff values to be more efficient in discriminating the prognosis in the subgroups of the TNM stages.

Conclusion

Individualized cutoff values of the preoperative CEA level are a more practical prognostic marker following and in harmony with the TNM staging system.

Citations

Citations to this article as recorded by  
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    BMJ Open.2024; 14(10): e084219.     CrossRef
  • Cell-free circulating ALU repeats in serum have a prognostic value for colorectal cancer patients
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  • Prognostic value of preoperative carcinoembryonic antigen and D-dimer concentrations in patients undergoing curative resection for colorectal cancer
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    World Journal of Surgery.2021; 45(5): 1514.     CrossRef
  • Diagnostic accuracy of follow‐up tests for detecting colorectal cancer recurrences in primary care: A systematic review and meta‐analysis
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    European Journal of Cancer Care.2021;[Epub]     CrossRef
  • Serum carcinoembryonic antigen pre‐operative level in colorectal cancer: revisiting risk stratification
    Cristiana Iacuzzo, Paola Germani, Marina Troian, Tommaso Cipolat Mis, Fabiola Giudici, Edoardo Osenda, Marina Bortul, Nicolò de Manzini
    ANZ Journal of Surgery.2021;[Epub]     CrossRef
  • The role of preoperative CEA in the management of colorectal cancer: A cohort study from two cancer centres
    Ali Riaz Baqar, Simon Wilkins, Margaret Staples, Chun Hin Angus Lee, Karen Oliva, Paul McMurrick
    International Journal of Surgery.2019; 64: 10.     CrossRef
  • Comparison of Four Automated Carcinoembryonic Antigen Immunoassays: ADVIA Centaur XP, ARCHITECT I2000sr, Elecsys E170, and Unicel Dxi800
    Joonhong Park, Seungok Lee, Yeongsic Kim, Aeran Choi, Hyeyoung Lee, Jihyang Lim, Yonggoo Kim, Kyungja Han, Eun-jee Oh
    Annals of Laboratory Medicine.2018; 38(4): 355.     CrossRef
  • Potential of quantitative SEPT9 and SHOX2 methylation in plasmatic circulating cell-free DNA as auxiliary staging parameter in colorectal cancer: a prospective observational cohort study
    Julia Bergheim, Alexander Semaan, Heidrun Gevensleben, Susanne Groening, Andreas Knoblich, Jörn Dietrich, Julia Weber, Jörg C. Kalff, Friedrich Bootz, Glen Kristiansen, Dimo Dietrich
    British Journal of Cancer.2018; 118(9): 1217.     CrossRef
  • Pre‐operative carcinoembryonic antigen predicts survival following colorectal cancer surgery with curative intent
    Ashok Gunawardene, Peter Larsen, Ali Shekouh, Elizabeth Dennett
    ANZ Journal of Surgery.2018; 88(12): 1311.     CrossRef
  • Accessing new prognostic significance of preoperative carcinoembryonic antigen in colorectal cancer receiving tumor resection: More than positive and negative
    Zerong Cai, Jian Xiao, Xiaosheng He, Jia Ke, Yifeng Zou, Yufeng Chen, Xianrui Wu, Xiaoling Li, Lei Wang, Jianping Wang, Ping Lan, Xiaojian Wu
    Cancer Biomarkers.2017; 19(2): 161.     CrossRef
  • A nanobody targeting carcinoembryonic antigen as a promising molecular probe for non-small cell lung cancer
    Hao Wang, Ai-Min Meng, Sheng-Hua Li, Xiao-Liang Zhou
    Molecular Medicine Reports.2017; 16(1): 625.     CrossRef
  • Valor pronóstico pretratamiento del antígeno carcinoembrionario en el cáncer colorrectal operado. ¿Es útil en todos los estadios del tumor?
    Ana Borda, Carlos Prieto, Javier Jiménez, Juan Vila, José Manuel Zozaya, Fernando Borda
    Gastroenterología y Hepatología.2016; 39(3): 191.     CrossRef
  • Prognostic value of preoperative carcinoembryogenic antigen: Is it useful in all stages of colorectal cancer?
    Ana Borda, Carlos Prieto, Javier Jiménez, Juan Vila, José Manuel Zozaya, Fernando Borda
    Gastroenterología y Hepatología (English Edition).2016; 39(3): 191.     CrossRef
  • Analysis of colorectal cancer glyco‐secretome identifies laminin β‐1 (LAMB1) as a potential serological biomarker for colorectal cancer
    Qifeng Lin, Hannah S.R. Lim, Hui Ling Lin, Hwee Tong Tan, Teck Kwang Lim, Wai Kit Cheong, Peh Yean Cheah, Choong Leong Tang, Pierce K. H. Chow, Maxey C. M. Chung
    PROTEOMICS.2015; 15(22): 3905.     CrossRef
  • Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable
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    International Surgery.2015; 100(4): 617.     CrossRef
  • Carcinoembryonic antigen levels in colorectal cancer: Are we too preoccupied?
    G Aggarwal, MK Roy, S Banerjee
    Indian Journal of Cancer.2014; 51(4): 452.     CrossRef
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    Expert Review of Proteomics.2014; 11(2): 227.     CrossRef
  • Individualized Cutoff Value of the Serum Carcinoembryonic Antigen Level According to TNM Stage in Colorectal Cancer
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    Annals of Coloproctology.2013; 29(3): 91.     CrossRef
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