Albert, Swenne (2024) Endoscopic Assessment in Preoperative Staging of Early Stage Colon Cancer is as Accurate as Conventional Radiological Evaluation: A Retrospective Analysis of Endoscopic Versus Radiological Assessment. thesis, Medicine.
Full text available on request.Abstract
Background: Colon cancer is the fourth most common type of cancer in the Netherlands. Due to the national screening programme, early stage colon cancer (T1-T2) has become increasingly prevalent. This creates opportunities for research on new less invasive treatments to avoid over-treatment and reduce postoperative complications. Improved preoperative staging is crucial to ensure accurate patient selection for these treatment options. The current standard, radiological assessment, has a low positive predictive value (PPV) of 57% for detecting early stage colon cancer. Therefore, this study explores if endoscopic assessment is more accurate at preoperatively staging early stage colon cancer than radiological assessment. Method: This retrospective study, conducted at Meander Medisch Centrum (MMC), enrolled patients in MMC with colon cancer in 2022. Each patient underwent index test A, radiological assessment of the abdominal computed tomography (CT) scan by a radiologist, index test B, assessment of endoscopic imaging by a gastroenterologist, and the reference diagnostic test, histopathological examination of the surgically obtained specimen. Therefore, each patient served as their own control in assessing accuracy of the index tests. Results: Among the 78 patients enrolled, 21 (26.9%) had early stage and 57 (73.1%) had late stage colon cancer. Endoscopic assessment had a PPV of 48.4%, which was not significantly higher than radiological assessment (40.5%), with a p value of 0.19. This indicates that endoscopic and radiological assessment are equally accurate at preoperatively staging early stage colon cancer. The specificity of endoscopic assessment, 71.9%, was significantly higher than radiological assessment, 61.4%, with a p value of 0.03. This implies that radiological assessment incorrectly identifies patients as having early stage colon cancer more frequently than endoscopic assessment. Conclusion: Radiological and endoscopic assessment are equally accurate at preoperative staging of early stage colon cancer. Endoscopic assessment has significantly higher specificity than radiological assessment. Further research, preferably prospectively, is justified to investigate the value of endoscopic assessment in preoperative staging of colon cancer with the aim of a proper patient inclusion in studies researching new treatments for early stage colon cancer.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | prof. dr. Consten, E.C.J. and drs. van de Laar, B.C.T. |
| Faculty: | Medical Sciences |
| Date Deposited: | 19 Aug 2024 10:59 |
| Last Modified: | 19 Aug 2024 10:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3742 |
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