title: Diagnostic value of preoperative CT scan to stratify colon cancer for neoadjuvant therapy.
abstract: OBJECTIVE
  Neoadjuvant therapy could improve oncological outcome of patients suffering from colon cancer. An accurate staging method is needed to define suitable patients. The aim of this retrospective study was to validate the value of CT for identifying patients with local advanced (T3/4) or nodal-positive colon cancer.
  
  
  METHODS
  Preoperative abdominal CT scans of 210 patients with colon cancer were evaluated by two radiologists independently for the T stage and N stage. Results were compared to pathology. Patients were stratified according to the guidelines for rectal cancer into patients with low risk (T0/1/2 and N0) or high risk (T3/4 or N+).
  
  
  RESULTS
  Inter-observer correlation was high with over 90 %. Overall sensitivity T stage was 93.0 % and for N stage 76.9 %. Using CT scan to identify local advanced (T3/4 or N+) tumors, the consensus sensitivity was 94.9 %, the specificity 53.6 %, the positive predictive value (PPV) 92.8 %, and the negative predictive value (NPV) 62.5 %.
  
  
  CONCLUSIONS
  Computer tomography represents an effective tool for identifying patients with colon cancer suitable for neoadjuvant therapy according to the guidelines for rectal cancer.
authors.affiliation: Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Strasse 6, 97080, Wuerzburg, Germany, wiegering_a@ukw.de.
authors.forename: Armin
authors.initials: A
authors.lastname: Wiegering
authors.forename: Meik
authors.initials: M
authors.lastname: Kunz
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hussein
authors.forename: Ingo
authors.initials: I
authors.lastname: Klein
authors.forename: Verena
authors.initials: V
authors.lastname: Wiegering
authors.forename: Friedrich Wilhelm
authors.initials: FW
authors.lastname: Uthe
authors.forename: Ulrich A
authors.initials: UA
authors.lastname: Dietz
authors.forename: Christian
authors.initials: C
authors.lastname: Jurowich
authors.forename: Thorsten
authors.initials: T
authors.lastname: Bley
authors.forename: Thomas
authors.initials: T
authors.lastname: Dandekar
authors.forename: Christoph-Thomas
authors.initials: CT
authors.lastname: Germer
authors.forename: Christian
authors.initials: C
authors.lastname: Ritter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed