Clinical usefulness of chest radiography in detection of pulmonary metastases after curative resection for colorectal cancer.
OBJECTIVE
The purpose of this study was to evaluate the effectiveness of chest radiography (CXR) and abdominal computed tomography (CT) for detecting pulmonary metastases after curative surgery for colorectal cancer.


METHODS
We performed a retrospective analysis of the records of all patients with pulmonary metastasis from colorectal cancer who underwent curative resection between 1994 and 2004 at our institution.


RESULTS
Pulmonary metastases were detected in 193 patients by either CXR or abdominal CT. They were initially detected by CXR in 87 patients (45.1%) and by abdominal CT in 106 patients (54.9%). In the CXR group, the patterns of pulmonary recurrence were as follows: solitary (n = 38, 43.7%), multiple unilateral (n = 11, 12.6%), and multiple bilateral (n = 38, 43.7%). In the CT group, there were 22 patients (20.8%) with a solitary nodule, 17 patients (16.0%) with multiple unilateral nodules, and 67 (63.2%) with multiple bilateral nodules. The overall survivals of the CXR group and abdominal CT group were 34.6% and 31.7%, respectively (p = 0.312). There was no difference in the median disease-free interval between the CXR group and the abdominal CT group (23.8 vs. 23.2 months, p = 0.428).


CONCLUSIONS
Although this study is limited by its small sample size, it can be speculated that abdominal CT with lower thorax images may replace CXR in surveillance programs.
Lee
Won-Suk
WS
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Korea.
Yun
Seong Hyeon
SH
Chun
Ho-Kyung
HK
Lee
Woo Yong
WY
Yun
Haeran
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000000981:diagnostic imaging; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D002272:Carcinoembryonic Antigen