Compatibility of Local Staging (T) Colorectal Cancer in Multi-Slice Computed Tomography (MSCT) with Histopathology: a Retrospective Study
DOI:
https://doi.org/10.57125/FEM.2023.09.30.02Keywords:
Colorectal Cancer, Local Stage, Multislice Computerized Tomography, MSCTAbstract
Early staging of local tumors is very important in determining the prognostic and in the maximum therapeutic management.
Aims : The purpose of this study was to analyse the compatibility of local staging (T) of colorectal cancer on Multi-Slice Computed Tomography (MSCT) examination with histopathology.
Methodology: retrospective analytic observation design. The study sample was 34 colorectal cancer patients that met the research inclusion criteria. The research data were analysis by gamma coefficient test with a significance level of 0.05.
Results: the majority of patients were 45-65 years old (50%) and male (58.8%). 25 of 34 cases (73.5%) had the same local MSCT and histopathological staging, namely 18 of 19 cases of T3 (94.7%) and 7 of 14 cases of T2 (50%). 1 in 34 cases (2.9%) was under-staging, and 8 out of 34 cases (23.5%) was over-staging. The characteristics of colorectal cancer in the MSCT findings were a solid mass (70.6%), unclear boundaries (55.9%), irregular shape (91.2%), having mass morphology (85.3%), measuring 5-10 cm (55.9%), homogeneous enhancement pattern (70.6%), not invading surrounding organs (94.1%), located in the rectosigmoid (29.4%), and well-differentiated adenocarcinoma (67.6%). Statistical test obtained the results = 0.005 (≤ 0.05) with a gamma coefficient value of 0.787. The T3 sensitivity and specificity tests were 94.7% and 46.7%, respectively, with an accuracy of 73.5%, and the T2 sensitivity and specificity tests were 50.0% and 95.0%, with an accuracy of 76.5%.
Scientific Novelty: the reliability of MSCT as a local staging (T) determinant of colorectal cancer.
Conclusion: there is a significant agreement between local staging (T) colorectal cancer results from the msct examination and histopathological examination results with positive correlation properties and very strong correlation strength. Colonography MSCT examination can be an option to obtain maximum sensitivity of local stage T2 of colorectal cancer.
References
World Health Organization. GLOBOCAN - Colorectal Cancer Incidence in The World. Glob Cancer Obs 2020;419:1–2. https://gco.iarc.fr/today/data/factsheets/populations/900-world-fact-sheets.pdf
Anthonysamy MA, Indrayani Maker LPL, Gotra IM, Saputra H. Prevalence of colorectal carcinoma based on microscopic type, sex, age and anatomical location in Sanglah General Hospital. Intisari Sains Medis 2020;11:272. https://doi.org/10.15562/ism.v10i2.171.
The Global Cancer Observatory - Indonesia. Cancer Incident in Indonesia. Int Agency Res Cancer 2020;858:1–2. https://gco.iarc.fr/today/data/factsheets/populations/360-indonesia-fact-sheets.pdf
Kemenkes RI. Beban Kanker di Indonesia. Pus Data Dan Inf Kesehat Kementeri Kesehat RI 2019:1–16.
Fleming M, Ravula S, Tatishchev SF, Wang HL. Colorectal carcinoma: Pathologic aspects. J Gastrointest Oncol 2012;3:153–73. https://doi.org/10.3978/j.issn.2078-6891.2012.030.
Tamandl Di, Mang T, Ba-Ssalamah A. Imaging of colorectal cancer - The clue to individualized treatment. Innov Surg Sci 2018;3:3–15. https://doi.org/10.1515/iss-2017-0049.
Willett CG, Ryan DP. Neoadjuvant chemoradiotherapy, radiotherapy, and chemotherapy for rectal adenocarcinoma. Https://WwwUptodateCom/Contents/Neoadjuvant-Chemoradiotherapy-Radiotherapy-and-Chemotherapy-for-Rectal-Adenocarcinoma 2022.
Richie AJ, Mellonie P, Suresh HB. Diagnostic Accuracy of Pre-operative Staging of Colorectal Carcinoma in Comparison to Postoperative Pathological Staging. Int J Sci Study 2016;4:38–41. https://doi.org/10.17354/ijss/2016/370.
ACS. Colorectal Cancer Facts and Figures 2020-2022. Am Cancer Soc 2020;66:1–41. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/colorectal-cancer-facts-and-figures/colorectal-cancer-facts-and-figures-2020-2022.pdf
Kemenkes RI. Panduan Penatalaksanaan Kanker kolorektal. Kementeri Kesehat Republik Indones 2016.
Sawicki T, Ruszkowska M, Danielewicz A, Niedźwiedzka E, Arłukowicz T, Przybyłowicz KE. A review of colorectal cancer in terms of epidemiology, risk factors, development, symptoms and diagnosis. Cancers (Basel) [Internet]. 2021;13(9):2025. Available from: http://dx.doi.org/10.3390/cancers13092025
Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin 2020;70:145–64. https://doi.org/10.3322/caac.21601.
Siegel RL, Jakubowski CD, Fedewa SA, Davis A, Azad NS. Colorectal cancer in the young: Epidemiology, prevention, management. Am Soc Clin Oncol Educ Book [Internet]. 2020;(40):e75–88. Available from: http://dx.doi.org/10.1200/edbk_279901
Li ZH, You DY, Gao DP, Yang GJ, Dong XX, Zhang DF, et al. Role of CT scan in differentiating the type of colorectal cancer. Onco Targets Ther 2017;10:2297–303. https://doi.org/10.2147/OTT.S131008.
Saran Lotfollahzadeh, Recio-Boiles A, Cagir B. Colon Cancer. https://www.ncbi.nlm.nih.gov/books/NBK470380/
Ottaiano A, Santorsola M, Perri F, Pace U, Marra B, Correra M, et al. Clinical and molecular characteristics of rare malignant tumors of colon and rectum. Biology (Basel) [Internet]. 2022;11(2):267. Available from: http://dx.doi.org/10.3390/biology11020267
Xi Y, Xu P. Global colorectal cancer burden in 2020 and projections to 2040. Transl Oncol 2021;14:101174. https://doi.org/10.1016/j.tranon.2021.101174.
Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: Incidence, mortality, survival, and risk factors. Prz Gastroenterol 2019;14:89–103. https://doi.org/10.5114/pg.2018.81072.
Kasi A, Handa S, Bhatti S, Umar S, Bansal A, Sun W. Molecular Pathogenesis and Classification of Colorectal Carcinoma. Curr Colorectal Cancer Rep 2020;16:97–106. https://doi.org/10.1007/s11888-020-00458-z.
Makmun D, Simadibrata M, Abdullah M, Syam AF, Shatri H, Fauzi A, et al. Colorectal cancer patients in a tertiary hospital in Indonesia: Prevalence of the younger population and associated factors. World J Clin Cases 2021;9:9804–14. https://doi.org/10.12998/wjcc.v9.i32.9804.
Beni M, Nuriya Widyasari M, Eka Listiana D, Yuliastuti T. Kesesuaian Hasil Pemeriksaan Computed Tomography (CT) Scan Abdomen Kontras dengan Hasil Pemeriksaan Histopatologi (Studi pada Pasien dengan Keganasan Kolorektal). Medica Hosp J Clin Med 2022;9:207–13. https://doi.org/10.36408/mhjcm.v9i2.760.
Heo SH, Kim JW, Shin SS, Jeong YY, Kang HK. Multimodal imaging evaluation in staging of rectal cancer. World J Gastroenterol 2014;20:4244–55. https://doi.org/10.3748/wjg.v20.i15.4244.
Singla S, Kaushal D, Sagoo H, Calton N. Comparative analysis of colorectal carcinoma staging using operative, histopathology and computed tomography findings. Int J Appl Basic Med Res 2017;7:10. https://doi.org/10.4103/2229-516x.198501.
Baeßler B, Maintz D, Persigehl T. Imaging procedures for colorectal cancer. Visc Med 2016;32:166–71. https://doi.org/10.1159/000446143.
Nasseri Y, Langenfeld SJ. Imaging for colorectal cancer. Surg Clin North Am [Internet]. 2017;97(3):503–13. Available from: http://dx.doi.org/10.1016/j.suc.2017.01.002
Richie AJ, Mellonie P, Suresh HB. Accuracy of Multidetector Computer Tomography in Differentiating Benign and Malignant Colorectal Lesions with Histopathological Correlation. Int J Sci c Study 2016;4:2–8. https://doi.org/10.17354/ijss/2016/257.
American College of Radiology. American College of Radiology ACR Appropriateness Criteria® Staging of Colorectal Cancer Variant. Am Coll Radiol 2021.
So JS, Cheong C, Oh SY, Lee JH, Kim YB, Suh KW. Accuracy of preoperative local staging of primary colorectal cancer by using computed tomography: Reappraisal based on data collected at a highly organized cancer center. Ann Coloproctol 2017;33:192–6. https://doi.org/10.3393/ac.2017.33.5.192.
Yang B, Gan Z, Liu S, Li M, Si G, He Q. Value of multi-slice spiral computerized tomography for diagnosis of synchronous colorectal carcinoma: a retrospective study. J Int Med Res 2022;50. https://doi.org/10.1177/03000605221076060.
Reali C, Bocca G, Lindsey I, Jones O, Cunningham C, Guy R, et al. Influence of incorrect staging of colorectal carcinoma on oncological outcome: are we playing safely? Updates Surg 2022;74:591–7. https://doi.org/10.1007/s13304-021-01095-3.
Zhou XC, Chen QL, Huang CQ, Liao HL, Ren CY, He QS. The clinical application value of multi-slice spiral CT enhanced scans combined with multiplanar reformations images in preoperative T staging of rectal cancer. Med (United States) 2019;98. https://doi.org/10.1097/MD.0000000000016374.
Scheele J, Schmidt SA, Tenzer S, Henne-Bruns D, Kornmann M. Overstaging: A Challenge in Rectal Cancer Treatment. Visc Med 2018;34:301–6. https://doi.org/10.1159/000488652.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 authors
This work is licensed under a Creative Commons Attribution 4.0 International License.
