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BMC Cancer

, 11:433

Clinical oncology


BackgroundAdvanced colorectal cancer CRC, either locally advanced, metastasized mCRC or both, is present in a relevant proportion of patients. The chances on curation of advanced CRC are continuously improving with modern multi-modality treatment options. For incurable CRC the focus lies on palliation of symptoms, which is not necessarily a resection of the primary tumor. Both situations motivate adequate staging before treatment in CRC. This prospective observational study evaluates the outcomes after the introduction of routine staging with abdominal CT before treatment.

MethodsIn a prospective observational study of 612 consecutive patients 2007-2009, the ability of abdominal CT to find liver metastases LM, peritoneal carcinomatosis PC and T4 stage in colon cancer CC was analysed.

ResultsAdvanced CRC was present in 58% of patients, mCRC in 31%. The ability to find LM was excellent 99%, cT4 stage CC good 86% and PC poor 33%. In the group of surgical patients with emergency presentations, the incidences of both mCRC 51% and locally advanced colon cancer LACC 69% were higher than in the elective group 20% and 26% respectively. Staging tended to be omitted more often in the emergency group 35% versus 12% in elective surgery.

ConclusionsThe strengths of staging with abdominal CT are to find LM and LACC, however it fails in diagnosing PC. On grounds of the incidence of advanced CRC, staging is warranted in patients with emergency presentations as well.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2407-11-433 contains supplementary material, which is available to authorized users.

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Autor: Irene Grossmann - Joost M Klaase - Johannes KA Avenarius - Ignace HJT de Hingh - Walter JB Mastboom - Theo Wiggers


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