Colon cancer patients routinely undergo preoperative computed tomography scanning.
However, local staging is thought to be inaccurate.
Dr Gina Brown and colleagues from England determined if clinical outcome could be predicted from radiological features of the primary tumor.
The team evaluated consecutive patients at a single hospital undergoing primary resection for colon cancer from 2000 to 2004.
Patients with visible metastases were excluded.
|Relapse-free survival was 71% in those with a ‘good' prognosis|
|British Journal of Cancer|
Preoperative computed tomography scans were reviewed independently by 2 radiologists blinded to histological stage and outcome.
The research team reviewed 126 preoperative computed tomography scans.
Images of the primary tumor were evaluated according to conventional tumor, node and metastases criteria.
The research team stratified the patients into 'good' or 'poor' prognosis groups.
The researchers made comparisons between the prognostic group, and actual clinical outcome.
The team found that tumor-stage and nodal status was correctly predicted in only 60% of the group with a good prognosis.
The research team observed that tumor-stage and nodal status was correctly predicted in 62% of that group.
However, the inter-observer agreement for the prognostic group was 79%.
The team noted that the 3-year relapse-free survival was 71% and 43% for the computed tomography-predicted 'good' and 'poor' groups, respectively.
This compared favorably with the histology-predicted prognostic groups.
Dr Brown's team, “Computed tomography is a robust method for stratifying patients preoperatively, with similar accuracy to histopathology for predicting outcome.”
“Recognition of poor prognosis tumors preoperatively may permit investigation into the future use of neo-adjuvant therapy in colon cancer."