Consequences of CT colonography in stenosing colorectal cancer.
BACKGROUND
In patients with stenosing colorectal cancer (CRC), visualization of the entire colon prior to surgery is recommended to exclude synchronous tumors. Therefore, most centers combine computed tomographic colonography (CTC) with staging CT. The aims of this study were to evaluate the yield and clinical implications of CTC.


METHODS
In this multicenter retrospective study, patients with stenosing CRC that underwent CTC and subsequent surgery between April 2013 and November 2015 were included. Result of the CTC, its influence on the surgical treatment plan, and final histology report were evaluated.


RESULTS
One hundred sixty-two patients with stenosing CRC were included. Nine (5.6 %) synchronous cancers proximal to the stenosing tumor were suspected with CTC. In four of nine patients, the CTC did not change the primary surgical plan because the tumors were located in the same surgical segment. In five of nine patients, CTC changed the surgical treatment plan. Three of these five patients underwent an extended resection and the presence of the tumors was confirmed. Two of these three synchronous CRCs were also visible on abdominal staging CT. In the other two patients, the result of CTC was false positive which led to an unnecessary extended resection in one patient.


CONCLUSION
The yield of CTC was relatively low. In only three patients (1.9 %), CTC correctly changed the primary surgical plan, but in two of them, the tumor was also visible on abdominal staging CT. Moreover, in two patients, CTC was false positive. The clinical value of CTC in stenosing CRC appears to be limited.
['Huisman|J F|JF|', 'Leicher|L W|LW|', 'de Boer|E|E|', 'van Westreenen|H L|HL|', 'de Groot|J W|JW|', 'Holman|F A|FA|', 'van de Meeberg|P C|PC|', 'Sallevelt|Pejm|P|', 'Peeters|Kcmj|K|', 'Wasser|Mnjm|M|', 'Vasen|Hfa|H|', 'de Vos Tot Nederveen Cappel|W H|WH|']
D000368:Aged D003113:Colonoscopy D015179:Colorectal Neoplasms D003251:Constriction, Pathologic D005260:Female D006801:Humans D008297:Male D011182:Postoperative Care D014057:Tomography, X-Ray Computed
CT colonography Stenosing Colorectal cancer Obstructive