Accuracy of helical computed tomography in the detection of pulmonary colorectal metastases.
OBJECTIVE
This study assessed the sensitivity of helical computed tomography in the detection of pulmonary metastases in patients with colorectal cancer and the role of video-assisted thoracoscopic surgery in patients with pulmonary metastases.


METHODS
A total of 120 operations for pulmonary metastases were performed in 91 patients with colorectal cancer. All patients received an open thoracotomy that allowed full operative inspection and palpation. Clinical data, including the size and number of pulmonary metastasis, were retrospectively collected. The difference in the number of pulmonary metastases as determined by computed tomography scan and surgical findings was determined and analyzed.


RESULTS
Operative findings were consistent with the preoperative computed tomography scan reports in 64 of the 120 operations (53.3%). In 32 operations (26.7%), additional metastatic tumors were identified at open thoracotomy. The sensitivity of helical computed tomography in the detection of colorectal cancer metastatic lesions ranged from 35.5% to 95.5%. Unilateral solitary lesion demonstrated on computed tomography scan was an independent factor for the prediction of additional metastatic lesions (P = .023).


CONCLUSIONS
The sensitivity of helical computed tomography scan in the detection of pulmonary metastases can reach 95.5% in patients with colorectal cancer with a solitary metastatic lesion. A unilateral solitary lesion demonstrated on preoperative computed tomography scan is an independent factor for prediction of additional metastatic lesions. If feasible, video-assisted thoracoscopic surgery may be justified in patients with colorectal cancer with solitary pulmonary metastases.
Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Cheng-Ching
CC
Chung
Chih-Cheng
CC
Hsieh
Hui-Chen
HC
Lee
Mei-Han
MH
Wu
Min-Hsiung
MH
Huang
Wen-Hu
WH
Hsu
Han-Shui
HS
Hsu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010173:Palpation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D003074:Solitary Pulmonary Nodule / Q000000981:diagnostic imaging* / Q000556:secondary* / Q000601:surgery; D013624:Taiwan; D020775:Thoracic Surgery, Video-Assisted; D036542:Tomography, Spiral Computed