TY - JOUR
T1 - Cancer-induced spiculation on computed tomography
T2 - a significant preoperative prognostic factor for colorectal cancer
AU - Ao, Tadakazu
AU - Kajiwara, Yoshiki
AU - Yamada, Kentaro
AU - Shinto, Eiji
AU - Mochizuki, Satsuki
AU - Okamoto, Koichi
AU - Yamadera, Masato
AU - Yonemura, Keisuke
AU - Ueno, Hideki
N1 - Publisher Copyright:
© 2019, Springer Nature Singapore Pte Ltd.
PY - 2019/7/10
Y1 - 2019/7/10
N2 - Purpose: Cancer-induced spiculation (CIS) on computed tomography, which is reticular or linear opacification of the pericolorectal fat tissues around the cancer site, is generally regarded as cancer infiltration into T3 or T4, but its clinicopathological significance is unknown. This study examines the correlation between CIS and clinicopathological findings to establish its prognostic value. Methods: The subjects of this retrospective study were 335 patients with colorectal cancer (CRC), who underwent curative surgery between January, 2010 and December, 2011, at the National Defense Medical College Hospital in Saitama Prefecture, Japan. Results: The level of interobserver agreement in the evaluation of CIS was substantial (83%; kappa value, 0.65). The presence of CIS was specific for T3/T4 disease (positive predictive value, 88.3%), and was significantly associated with tumor size and venous invasion. The 5-year relapse-free survival rate was significantly lower in patients with CIS than in those without CIS (68.6% and 84.0%, respectively, p = 0.001). Subgroup analysis revealed remarkable prognostic differences in patients with stage III and T3 disease. Multivariate analysis revealed that CIS was a significant independent prognostic factor. Conclusions: CIS was a significant preoperative prognostic factor and could be useful in the selection of preoperative therapy for patients with CRC.
AB - Purpose: Cancer-induced spiculation (CIS) on computed tomography, which is reticular or linear opacification of the pericolorectal fat tissues around the cancer site, is generally regarded as cancer infiltration into T3 or T4, but its clinicopathological significance is unknown. This study examines the correlation between CIS and clinicopathological findings to establish its prognostic value. Methods: The subjects of this retrospective study were 335 patients with colorectal cancer (CRC), who underwent curative surgery between January, 2010 and December, 2011, at the National Defense Medical College Hospital in Saitama Prefecture, Japan. Results: The level of interobserver agreement in the evaluation of CIS was substantial (83%; kappa value, 0.65). The presence of CIS was specific for T3/T4 disease (positive predictive value, 88.3%), and was significantly associated with tumor size and venous invasion. The 5-year relapse-free survival rate was significantly lower in patients with CIS than in those without CIS (68.6% and 84.0%, respectively, p = 0.001). Subgroup analysis revealed remarkable prognostic differences in patients with stage III and T3 disease. Multivariate analysis revealed that CIS was a significant independent prognostic factor. Conclusions: CIS was a significant preoperative prognostic factor and could be useful in the selection of preoperative therapy for patients with CRC.
KW - Cancer-induced spiculation
KW - Colorectal cancer
KW - Computed tomography images
KW - Preoperative prognostic factor
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U2 - 10.1007/s00595-019-01780-2
DO - 10.1007/s00595-019-01780-2
M3 - Article
C2 - 30790053
AN - SCOPUS:85067620683
SN - 0941-1291
VL - 49
SP - 629
EP - 636
JO - Surgery Today
JF - Surgery Today
IS - 7
ER -