CT staging of colon cancer.
Computer tomography (CT) has been the principal investigation in the staging of colon cancers. The information obtained with routine CT has been limited to identifying the site of the tumour, size of the tumour, infiltration into surrounding structures and metastatic spread. The Foxtrot trial National Cancer Research Institute (NCRI) has been specifically designed to evaluate the efficacy of neoadjuvant treatment in colon cancers by using preoperative chemotherapy with or without an anti-Epidermal Growth Factor Receptor (EGFR) monoclonal antibody to improve outcome in high-risk operable colon cancer. Patients are selected based on their staging CT examination. The criteria for poor prognosis are T4 and T3 tumours with more than 5mm extramural depth. Thus the success of the trial would depend upon the confidence of the radiologist to identify the patients that would receive the neoadjuvant treatment. The aim of this review is to explain the process of identifying high-risk features seen on the staging CT images. This will help to identify a cohort of patients that could truly benefit from neoadjuvant strategies.
Dighe
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Department of Radiology, Royal Marsden Hospital, Sutton SM5 2TT, UK.
Swift
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Brown
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D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods*; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed