Selection of colon cancer patients for neoadjuvant chemotherapy by preoperative CT scan

A retrospective study of 117 patients with the diagnosis of colon cancer was performed to evaluate the clinical utility of the preoperative computed tomography (CT) scan and to assess the role of carcinoembryonic antigen (CEA) as a predictor of the need for CT scan in colon cancer patients. Forty-nine patients had a CT scan that altered their treatment. One hundred per cent of stage IV patients versus only 26.5 per cent of stage I, II, and III patients had their operative and/or treatment planning altered by the preoperative CT. The sensitivity of CT scan in predicting metastatic disease was 90.3 per cent. All patients with stage IV disease had an abnormal CEA (>3 ng/mL). There was 89.7 per cent of stage IV patients who had a CEA twice that of normal or above. By using a CEA level of 3.1 ng/mL or above as a prerequisite for preoperative tomography, 34 nonmetastatic patients would not have had preoperative CT scans. Using a prerequisite of 6.1 ng/mL or above, 49 nonmetastatic patients would not have had a preoperative CT scan, and 90 per cent of the stage IV patients would have been imaged. We recommend obtaining a preoperative CT scan on those patients with a CEA value twice that of normal or greater.

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486 Prognostic value of pet-ct scan on survival outcomes of advanced-staged ovarian cancer patients treated with neoadjuvant chemotherapy: a prospective study

10.1136/ijgc-2020-esgo.50 ◽

2020 ◽

Author(s):

Stamatios Petousis ◽

Anne-Laure Cazeau ◽

Amandine Crombe ◽

Chrysoula Margioula-Siarkou ◽

Michel Kind ◽

...

Keyword(s):

Ovarian Cancer ◽

Neoadjuvant Chemotherapy ◽

Prospective Study ◽

Ct Scan ◽

Cancer Patients ◽

Prognostic Value ◽

Survival Outcomes ◽

Pet Ct ◽

A Prospective Study ◽

Pet Ct Scan

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The impact of mismatch repair status to the preoperative staging of local colon cancer: Implications for clinical management.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.4_suppl.16 ◽

2020 ◽

Vol 38 (4_suppl) ◽

pp. 16-16

Author(s):

Torben Hansen ◽

Emilie Erbs ◽

Natacha D. Trabjerg ◽

Soeren Rafael Rafaelsen ◽

Jan Lindebjerg ◽

...

Keyword(s):

Colon Cancer ◽

Ct Scan ◽

Mismatch Repair ◽

Clinical Management ◽

Preoperative Staging ◽

Lymph Node Staging ◽

Cancer Group ◽

Preoperative Ct ◽

Pn Stage ◽

The Impact

16 Background: Computed tomography (CT) scan is standard in preoperative local staging of colon cancer. Tumours with a deficient mismatch repair (dMMR) system are characterised by unique clinical and pathophysiologic aspects that may impact on the accuracy of the preoperative CT staging. Methods: Data from the Danish Colorectal Cancer Group national clinical database addressing a cohort of patients operated for stage I-III colon cancer in 2010-15 was analysed. The analyses of MMR status had been conducted consecutively through means of immunohistochemistry. All CT scans were blindly assessed by a certified radiologist. Results: Data from 590 patients, operated at a specialised cancer centre were available for analyses. A dMMR phenotype was detected in 135 (22.9%) of the patients. The overall correlation of the clinical and pathological T-category was significant for both groups. There was inferior correlation between cN and pN (p > 0.05) in pMMR cancers with a higher degree of over-staging assessed by CT-scan, compared to a significant correlation between cN and pN stage in pMMR cancers (p < 0.01). Of the 91 dMMR tumours judged node-positive by the preoperative CT scan, 59 (64.8%) showed no sign of metastatic involvement at the postoperative assessment. Conclusions: The accuracy of preoperative CT lymph node staging in colon cancer seems to differ depending on MMR status and may impact the clinical management including the neoadjuvant setting.

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Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy

International Journal of Colorectal Disease ◽

10.1007/s00384-015-2265-z ◽

2015 ◽

Vol 30 (8) ◽

pp. 1067-1073 ◽

Cited By ~ 10

Author(s):

Armin Wiegering ◽

Meik Kunz ◽

Mohamed Hussein ◽

Ingo Klein ◽

Verena Wiegering ◽

...

Keyword(s):

Colon Cancer ◽

Ct Scan ◽

Neoadjuvant Therapy ◽

Diagnostic Value ◽

Preoperative Ct

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The Aggressive Surgical Treatment and Outcome of a Colon Cancer Patient Infected with SARS-CoV-2 in Wuhan, China and Our Experience Sharing

10.21203/rs.3.rs-23214/v1 ◽

2020 ◽

Author(s):

Jinbo Gao ◽

Ming Yang ◽

Lian Liu ◽

Shuang Guo ◽

Yongfeng Li ◽

...

Keyword(s):

Colon Cancer ◽

Surgical Treatment ◽

Cancer Patient ◽

Ct Scan ◽

Cancer Patients ◽

Epidemic Season ◽

First Case ◽

Abdomen Ct ◽

Novel Coronavirus ◽

Tissue Specimens

Abstract Background: Cancer patients are at increased risks of novelcoronavirus disease 2019 (COVID-19). Currently, surgical strategies for cancer patients with COVID-19 are generally suggested to be properly delayed. Case presentation:We presented a 69-year-old Chinese female colon cancer patientwith COVID-19, the first case accepted the surgical treatment during the epidemic season in China. Thepatient developed a fever on January 28, 2020. After treatments with Ceftriaxone and Abidol, her fever was not reduced yet. A repeat chest computed tomography (CT) scan showed the infectious lesions significantly exacerbated, with a positive result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleic acid. An abdomen CT scan indicated the tumor of ascending colon with local wrapped changes. She was diagnosed with ‘Severe novel coronavirus pneumonia’ and ‘Incomplete bowel obstruction: Colon cancer?’. After actively anti-inflammatory and anti-viral therapies, aright colectomy with lymph node dissection was performed on March 11. The pathological changes of tissue specimens were further investigated.The patient successfully recovered from COVID-19 and surgery, without any postoperative related complications, and was discharged on the 9th day after operation. No case of surgeon, nurse or anesthetist in our team infected by SARS-CoV-2 occurred. Microscopically, significant degeneration, necrosis and slough of focal intestinal and colonic mucosal epithelial cells were observed. Conclusions:It is meaningful and imperative to share our experience to protect health care personnel from SARS-CoV-2infection and to provide references for optimizing treatment of cancer patient, at least for the operative intervention absolutely necessary or emergency surgery,during the outbreak of COVID-19.

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