title: Consequences of CT colonography in stenosing colorectal cancer.
abstract: BACKGROUND
  In patients with stenosing colorectal cancer (CRC), visualization of the entire colon prior to surgery is recommended to exclude synchronous tumors. Therefore, most centers combine computed tomographic colonography (CTC) with staging CT. The aims of this study were to evaluate the yield and clinical implications of CTC.
  
  
  METHODS
  In this multicenter retrospective study, patients with stenosing CRC that underwent CTC and subsequent surgery between April 2013 and November 2015 were included. Result of the CTC, its influence on the surgical treatment plan, and final histology report were evaluated.
  
  
  RESULTS
  One hundred sixty-two patients with stenosing CRC were included. Nine (5.6 %) synchronous cancers proximal to the stenosing tumor were suspected with CTC. In four of nine patients, the CTC did not change the primary surgical plan because the tumors were located in the same surgical segment. In five of nine patients, CTC changed the surgical treatment plan. Three of these five patients underwent an extended resection and the presence of the tumors was confirmed. Two of these three synchronous CRCs were also visible on abdominal staging CT. In the other two patients, the result of CTC was false positive which led to an unnecessary extended resection in one patient.
  
  
  CONCLUSIONS
  The yield of CTC was relatively low. In only three patients (1.9 %), CTC correctly changed the primary surgical plan, but in two of them, the tumor was also visible on abdominal staging CT. Moreover, in two patients, CTC was false positive. The clinical value of CTC in stenosing CRC appears to be limited.
authors: Department of Gastroenterology and Hepatology, P.O. box 10400, Isala, 8000 GK, Zwolle, the Netherlands. j.f.huisman@isala.nl.
authors: J F
authors: JF
authors: Huisman
authors: Department of Gastroenterology and Hepatology, P.O. box 10400, Isala, 8000 GK, Zwolle, the Netherlands.
authors: L W
authors: LW
authors: Leicher
authors: Department of Radiology, Isala, Zwolle, the Netherlands.
authors: E
authors: E
authors: de Boer
authors: Department of Surgery, Isala, Zwolle, the Netherlands.
authors: H L
authors: HL
authors: van Westreenen
authors: Department of Medical Oncology, Isala, Zwolle, the Netherlands.
authors: J W
authors: JW
authors: de Groot
authors: Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors: F A
authors: FA
authors: Holman
authors: Department of Gastroenterology and Hepatology, Slingeland hospital, Doetinchem, the Netherlands.
authors: P C
authors: PC
authors: van de Meeberg
authors: Department of Radiology, Slingeland hospital, Doetinchem, the Netherlands.
authors: Pejm
authors: P
authors: Sallevelt
authors: Department of Surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors: Kcmj
authors: K
authors: Peeters
authors: Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
authors: Mnjm
authors: M
authors: Wasser
authors: Dept of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, the Netherlands.
authors: Hfa
authors: H
authors: Vasen
authors: Department of Gastroenterology and Hepatology, P.O. box 10400, Isala, 8000 GK, Zwolle, the Netherlands.
authors: W H
authors: WH
authors: de Vos Tot Nederveen Cappel
mesh_terms: D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care; D014057:Tomography, X-Ray Computed
keywords: CT colonography; Colorectal cancer; Obstructive; Stenosing