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Accuracy of Preoperative Computed Tomography for Lymph Node Status Screening in Colon Cancer
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Original Article
VOLUME: 54 ISSUE: 3
P: 328-334
2021

Accuracy of Preoperative Computed Tomography for Lymph Node Status Screening in Colon Cancer

Acta Haematol Oncol Turc 2021;54(3):328-334
DOI: 10.5505/aot.2021.37790
Mustafa Taner Bostancı 1
Ibrahim Yilmaz 1
Yeliz Akturk 2
Aysun Gökçe 3
Mehmet Saydam 1
Işıl Esen Bostancı 4
1. University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of General Surgery, Ankara
2. University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Radiology, Ankara
3. University of Health Sciences, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Pathology, Ankara
4. University of Health Sciences, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Department of Radiology, Ankara
5.
No information available.
No information available
Received Date: 2021-03-20T15:34:54
Accepted Date: 2021-12-01T07:08:32
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Abstract

INTRODUCTION

Our aim is to determine the value of a pre-operative Computed Tomography (CT) scan for the assessment of lymph node status in patients diagnosed with colon cancer by comparing between radiological N-stage and histopathological N-stage.

METHODS

After approving by local ethics committee, an experinced radiologist reviewed all pre-operative CT scans of patients diagnosed with colon cancer retrospectively, between January 2014 and December 2018. The CT scans were examined for any signs of regional lymphatic spread which was defined as lymph nodes exceeding 1 cm, clusters of ≥3 lymph nodes or a combination of the two. The results were compared with the histopathological N-stage. The diffrences in comparison were eveluated statistically and positive predictive value (PPV), negative predictive value (NPV), sensitivity, specificity and accuracy were calculated.

RESULTS

We included 184 patients in our study. The statistical values of PPV, NPV, sensitivity, specificity, and accuracy of detecting regional lymph nodes metastases were 65.6%, 75%, 58.3%, 80.3% and 71.7%, respectively. The assessment of lymph node status with CT resulted in a moderate sensitivity, specificity and accuracy for both subgroups, defined as emergency and tumor localization subgroups.

DISCUSSION AND CONCLUSION

Although our study group is relatively large and homogeneous compared to previous studies, the obtained results in the evaluation of patients with colon cancer with preoperative CT does not seem to be satisfactory. Before making the treatment decisions according to the appearance of lymph nodes in colon cancer patients on CT images, the diagnostic accuracy needs strong improvement, such as thinner axial slices and three-dimensional reconstruction methods.