Adenocarcinoma/diagnostic imaging ; Adenocarcinoma/pathology* ; Adenocarcinoma/secondary* ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Colonic Polyps/diagnostic imaging ; Colonography, Computed Tomographic/methods* ; Colorectal Neoplasms/diagnostic imaging* ; Colorectal Neoplasms/secondary* ; Contrast Media ; Early Detection of Cancer ; Female ; Gastrectomy ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Care ; Stomach Neoplasms/diagnostic imaging ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery
Keywords
CT colonography ; gastric cancer ; colorectal cancer ; postoperative surveillance
Abstract
AIM: The purpose was to evaluate the diagnostic role of contrast-enhanced CT colonography (CTC) for follow-up of colorectal cancer screening after curative gastrectomy in patients with gastric adenocarcinomas.
MATERIALS AND METHODS: Contrast-enhanced CTC was performed as a substitute for routine follow-up CT for the detection of recurrent lesions in 700 consecutive patients who underwent curative surgery for gastric adenocarcinomas. Prospectively, patients with polyps measuring 6 mm or larger on CTC were referred for optical colonoscopy. Clinical and radiologic follow-up with respect to detection of polyp and recurrent lesion was retrospectively assessed.
RESULTS: Colorectal polyps measuring 6 mm or larger were identified by CTC in 104 (14.9%) of the 700 patients. Optical colonoscopy was recommended to these patients and was performed in 72 cases. True positive lesions were identified in 62 of the 72 patients (per-patient positive predictive value: 86.1%). The diagnostic yield for primary colonic malignancies was 1.6% (11/700). Recurrent lesions of gastric cancer were also detected in eight patients (1.1%).
CONCLUSION: In patients who undergo gastrectomy due to gastric adenocarcinoma, contrast-enhanced CTC may offer a unique advantage by allowing simultaneous colorectal cancer screening in addition to its routine role of detecting recurrent lesions during follow-up