title: Value of cardiophrenic angle lymph node for the diagnosis of colorectal peritoneal carcinomatosis.
abstract: BACKGROUND
  Cardiophrenic angle lymph nodes (CPALN) have been reported in patients with abdominopelvic malignancies. We aimed to assess whether the presence of CPALN is associated with peritoneal carcinomatosis (PC) in colorectal cancer.
  
  
  METHODS
  Between 2007 and 2011, 550 patients with colorectal cancer, including 165 (30%) with PC, had undergone surgery with complete peritoneal exploration. We retrospectively reviewed preoperative CT scans for the presence of CPALN and assessed its association with confirmed PC by univariate and multivariate analyses.
  
  
  RESULTS
  CPALN were present in 123 (75%) patients with PC, but absent in 263 (68%) patients without PC (Se: 0.72; Sp: 0.68; PPV: 0.49; NPV: 0.85; [OR], 3.3; p<0.001). PC was the only factor independently associated with CPALN in the multivariate analysis. CPALN was not correlated with the presence of liver metastases. 99 of the 165 patients with PC (62%) had visible signs of PC on CT scan. Among the remaining 66 patients, CPALN were the only potential sign of PC in 41 (62%), (Se 0.62, Sp 0.68, PPV 0.24, and NPV 0.92).
  
  
  CONCLUSIONS
  The detection of CPALN on CT may be of valuable help for the diagnosis of PC in patients with CRC.
authors.affiliation: Department of Radiology, Gustave Roussy Institute, Villejuif, France. Electronic address: caroline.caramella@igr.fr.
authors.forename: C
authors.initials: C
authors.lastname: Caramella
authors.forename: E
authors.initials: E
authors.lastname: Pottier
authors.forename: I
authors.initials: I
authors.lastname: Borget
authors.forename: D
authors.initials: D
authors.lastname: Malka
authors.forename: D
authors.initials: D
authors.lastname: Goéré
authors.forename: V
authors.initials: V
authors.lastname: Boige
authors.forename: C
authors.initials: C
authors.lastname: Honoré
authors.forename: P
authors.initials: P
authors.lastname: Dartigues
authors.forename: F
authors.initials: F
authors.lastname: Dumont
authors.forename: M
authors.initials: M
authors.lastname: Ducreux
authors.forename: D
authors.initials: D
authors.lastname: Elias
authors.forename: C
authors.initials: C
authors.lastname: Dromain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology*; D003964:Diaphragm; D005260:Female; D006801:Humans; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010496:Pericardium; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000556:secondary*; D010537:Peritoneum / Q000000981:diagnostic imaging; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Colorectal cancer; Early diagnosis; Lymph nodes; Peritoneal cavity