title: Should preoperative chest CT be recommended to all colon cancer patients?
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy of preoperative chest computed tomography (CT) and the risk factors for lung metastasis in colon cancer patients without liver metastasis who had negative findings on initial chest X-ray (CXR).
  
  
  BACKGROUND
  Preoperative staging with chest CT is recommended in colon cancer patients. However, there have been only scant data on the clinical efficacy.
  
  
  METHODS
  Three hundred nineteen consecutive colon cancer patients without liver metastasis were retrospectively reviewed and analyzed. The patients had negative findings on preoperative CXR, and they underwent surgery for colon cancer during the period of January 2008 to April 2010.
  
  
  RESULTS
  Lung nodule on chest CT was found in 136 patients (42.6%). Twenty of those were definitely diagnosed with lung metastasis (6.3%) by follow-up chest CT or pathologic confirmation. There was no case of delay in surgery due to findings of lung nodule. Comparing the group with lung metastases to that without lung metastases, postoperative pathologic findings reported more advanced T and N status (P = 0.004, P < 0.001, respectively), and lymphatic invasion was more frequent (P = 0.003) in the group with lung metastasis. By multivariate analysis, CT-predicted lymph node metastases and pathologic lymph node metastases were risk factors for lung metastases.
  
  
  CONCLUSIONS
  Preoperative staging chest CT is not beneficial to colon cancer patients without liver metastasis and lymph node metastasis suggested on abdominal and pelvic CT who had negative finding on initial CXR.
authors: Departments of *Medicine †Radiology; and ‡Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Hye Young
authors: HY
authors: Kim
authors: Soon Jin
authors: SJ
authors: Lee
authors: Gilsun
authors: G
authors: Lee
authors: Limwha
authors: L
authors: Song
authors: Su-A
authors: SA
authors: Kim
authors: Jin Yong
authors: JY
authors: Kim
authors: Dong Kyung
authors: DK
authors: Chang
authors: Poong-Lyul
authors: PL
authors: Rhee
authors: Jae J
authors: JJ
authors: Kim
authors: Jong Chul
authors: JC
authors: Rhee
authors: Ho-Kyung
authors: HK
authors: Chun
authors: Young-Ho
authors: YH
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003110:Colonic Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D016037:Single-Blind Method; D014057:Tomography, X-Ray Computed