November 2017 Vol. 5 No.11

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Original Research Article

Preoperative evaluation of colorectal cancer: accuracy of tumor localization by computed tomography scan and colonoscopy in comparison to the surgical findings

Amir Mari*, Fadi Abu-Backer, Dan Feldman, Oren Gal, Roman Dapssames, Baruch Ovadia and Yael Kopelman

Hillel Yaffe Medical Center, Hadera, Israel. Affiliated to Ruth and Rappaport Faculty of Medicine, Haifa, Israel

*Corresponding Author’s E-mail: Amir.Mari@hotmail.com
Tel: + 972 4 6304683
Fax: + 972 4 6304408

Accepted November 13, 2017

Abstract

The accuracy of colorectal tumor localization is most significant in the preoperative stage. Colonoscopy and CT tests are extremely important for tumor localization and are usually used as complementary tests. This study examined the level of accuracy of abdominal CT and colonoscopy in the localization colorectal tumors, based on the findings of these tests in the same patient and in comparison with the precise location determined during the surgery. The effect of several factors (tumor size, morphology, pathology) on the accuracy of tumor localization was examined. A retrospective observational study conducted in patients who underwent surgery for colorectal tumor resection at the Hillel Yaffe MC between 2007 – 2014. 256patient charts containing preoperative colonoscopy report, CT, surgical and tumor pathology report were reviewed. The tumor location as determined by colonoscopy and CT was compared to its exact location in surgery. Mean age 68 years. 136 (53%) females. Correlation between CT and surgery was 61% (kappa 0.08) between colonoscopy and surgery was 81% (kappa 0.77).Overall correlation between CT, colonoscopy and surgery was 54%. Tumor size was directly proportional to the level of correlation between the CT and surgery. No single parameter influenced the level of correlation between the colonoscopy and the surgery. CT scan failed to diagnose the tumor in one fifth of the patients. To conclude, colonoscopy is more accurate in ensuring proper preoperative tumor localization. CT scans should be further used as a complementary test, mainly to determine the extent of disease spread.

Keywords: Colorectal cancer, Localization, CT, Colonoscopy, Surgery