Location of colorectal cancer: colonoscopy versus surgery. Yield of colonoscopy in predicting actual location

 

 Permissions and Reprints

Abstract

Background and study aims Recent studies suggest that differences in biological characteristics and risk factors across cancer site within the colon and rectum may translate to differences in survival. It can be challenging at times to determine the precise anatomical location of a lesion with a luminal view during colonoscopy. The aim of this study is to determine if there is a significant difference between the location of colorectal cancers described by gastroenterologists in colonoscopies and the actual anatomical location noted on operative and pathology reports after colon surgery.

Patients and methods A single-center retrospective analysis of colonoscopies of patient with reported colonic masses from January 2005 to April 2014 (n = 380) was carried. Assessed data included demography, operative and pathology reports. Findings were compared: between the location of colorectal cancers described by gastroenterologists in colonoscopies and the actual anatomical location noted on operative reports or pathology samples.

Results We identified 380 colonic masses, 158 were confirmed adenocarcinomas. Of these 123 underwent surgical resection, 27 had to be excluded since no specific location was reported on their operative or pathology report. An absolute difference between endoscopic and surgical location was found in 32 cases (33 %). Of these, 22 (23 %) differed by 1 colonic segment, 8 (8 %) differed by 2 colonic segments and 2 (2 %) differed by 3 colonic segments.

Conclusion There is a significant difference between the location of colorectal cancers reported by gastroenterologists during endoscopy and the actual anatomical location noted on operative or pathology reports after colon surgery. Endoscopic tattooing should be used when faced with any luminal lesions of interest.

• References

• 1 Jass JR. Colorectal cancer: a multipathway disease. Crit Rev Oncol 2006; 12: 273-287
  CrossrefPubMedGoogle Scholar
• 2 Derwinger K, Gustavsson B. Variations in demography and prognosis by colon cancer location. Anticancer Research 2011; 31: 2347-2350
  PubMedGoogle Scholar
• 3 Jass JR. Molecular heterogeneity of colorectal cancer: Implications for cancer control. Surg Oncol 2007; 16 (Suppl. 01) S7-S9
  PubMedGoogle Scholar
• 4 Phipps AI, Lindor NM, Jenkins MA. et al. Colon and rectal cancer survival by tumor location and microsatellite instability: the colon cancer family registry. Dis Colon Rectum 2013 56: 937-944
  PubMedGoogle Scholar
• 5 Hemminki K, Santi I, Weires M. et al. Tumor location and patient characteristics of colon and rectal adenocarcinomas in relation to survival and TNM classes. BMC Cancer 2010; 10: 688
  CrossrefPubMedGoogle Scholar
• 6 Baxter NN, Goldwasser MA, Paszat LF. et al. Association of colonoscopy and death from colorectal cancer. Ann Intern Med 2009; 150: 1-8
  CrossrefPubMedGoogle Scholar
• 7 Landis JR, Koch G. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174
  CrossrefPubMedGoogle Scholar
• 8 Cho YB, Lee WY, Yun HR. et al. Tumor localization for laparoscopic colorectal surgery. World J Surg 2007; 31: 1491-1495
  CrossrefPubMedGoogle Scholar
• 9 Saleh F, Abbasi TA, Cleghorn M. et al. Preoperative endoscopy localization error rate in patients with colorectal cancer. Surg Endosc 2015; 29: 2569-2575
  CrossrefPubMedGoogle Scholar
• 10 Yap R, Ianno D, Burgess A. Colonoscopic localization accuracy for colorectal resections in the laparoscopic era. Am J Surg 2016; 212: 258-263
  CrossrefPubMedGoogle Scholar
• 11 Benedix F, Kube R, Meyer F. et al. Comparison of 17,641 patients with right- and left sided colon cancer: differences in epidemiology, perioperative course, histology, and survival. Dis Colon Rectum 2010; 53: 57-64
  CrossrefPubMedGoogle Scholar
• 12 Suttie SA, Shaikh I, Mullen R. et al. Outcome of right- and left-sided colonic and rectal cancer following surgical resection. Colorectal Dis 2011; 13: 884-889
  CrossrefPubMedGoogle Scholar
• 13 Meguid RA, Slidell MB, Wolfgang CL. et al. Is there a difference in survival between right-versus left-sided colon cancers?. Ann Surg Oncol 2008; 15: 2388-2394
  CrossrefPubMedGoogle Scholar
• 14 Wray CM, Ziogas A, Hinojosa MW. et al. Tumor subsite location within the colon is prognostic for survival after colon cancer diagnosis. Dis Colon Rectum 2009; 52: 1359-1366
  CrossrefPubMedGoogle Scholar
• 15 Shah SG, Pearson HJ, Moss S. et al. Magnetic endoscope imaging: a new technique for localizing colonic lesions. Endoscopy 2002; 34 (11) 900-904
  Article in Thieme ConnectPubMedGoogle Scholar
• 16 Acuna SA, Elmi M, Shah PS. et al. Preoperative localization of colorectal cancer: a systematic review and meta-analysis. Surg Endosc 2016; 31: 2366-2379
  PubMedGoogle Scholar
• 17 Kanazawa H, Utano K, Kijima S. et al. Combined assessment using optical colonoscopy and computed tomographic colonography improves the determination of tumor location and invasion depth. Asian J Endosc Surg 2016; 10: 28-34
  PubMedGoogle Scholar