Assessment Of Extramural Venous Invasion Detected By Preoperative Computed Tomography In Stage ? And ? Colon Cancer

Objectives To determine the 3-year progression free survival and overall survival of extramural venous invasion,detected with multiple-row detector computed tomography(ct EMVI),in patients with stage II and III colon cancers.Methods Clinical and follow-up data of 167 colon cancer patients underwent radial resection and with pathological-proved stage II and III colon cancer in North China University of science and Technology affiliated hospital,Tangshang Gongren hospital from March 2011 to March 2013 were included in this retrospective study.The assessment contents:Preoperative ct EMVI assessment of consistency analysis and comparison of clinicopathological information among them,the effect of preoperative ct EMVI on prognosis and its single factor,multivariate Cox regression analysis,and was analyze the prognosis of patients with preoperative ct EMVI in stage II colorectal cancer after chemotherapy.Preoperative CT imaging data were assessed by eextramural venous invasion by two imaging physicians.Stage III colon cancer patients were treated with conventional chemotherapy,For Stage II Colon Cancer According to the National Comprehensive Cancer Network Guidelines for the Clinical Practice of Colon Cancer.Stage II colon cancer risk assessment criteria for patients and their families are willing to give 1-7 courses of fluorouracil based adjuvant chemotherapy.All The included cases regularly review the chest,abdomen and pelvic CT.Results 1 Preoperative ct EMVI assessment of consistency: Inviting 10-year-old upper abdomen's CT examinations assess preoperative ct EMVI were enrolled 284 patients in this study.The results of the first observer were 211 cases in the ct EMVI negative group and 73 cases in the ct EMVI positive group.The results of the second observer were 186 cases in the ct EMVI negative group and 98 cases in the ct EMVI positive group.The coefficient of anastomosis of ct EMVI of stage ?and III colon cancer are respectively:k=0.683,P=0.000;k=0.689,P=0.000.The coefficient of anastomosis of ct EMVI of all is k=0.677,P=0.000.Good interobservers agreement was found for the evaluation.Controversial cases of 37 cases of imaging data by the third imaging physician to participate in the assessment and discussion with the other two imaging physicians to reach a consistent result: 186 cases in the extramural venous invasion negative group and 98 cases in the positive group,The positive rate of ct EMVI in the stage II and III colon cancer was respectively 23.95%(40/167),36.9%(42/117)).2 The 3-year progression free survival rate and overall survival of the negative group was significantly higher than that of positive group,There are statistical differences.However,the pathologic diagnosis stage II colorectal cancer ct EMVI of the positive group of 3-year disease-free survival,overall survival is same as stage III colorectal cancer ct EMVI negative group,it is no significant difference.3 In 40 cases of pathological diagnosis stage II colorectal cancer preoperative CT examine extramural venous invasion positive group 22 cases received adjuvant chemotherapy and 18 cases no received chemotherapy.Whether or not chemotherapy for the grouping of the pathological diagnosis of stage II colorectal cancer ct EMVI positive group further divided into two groups,and the 3-year disease-free survival rate,overall survival curve analysis.The difference between the two groups was significant by Log rank test.We could believe pathological diagnosis stage ? colorectal cancer ct EMVI group after postoperative adjuvant chemotherapy is improve to 3-year progression free survival and overall survival.It could improve to prognosis and have statistical significance.4 Cox univariate factor and multivariate regression analysis showed that ct EMVI is a risk factor for the 3-year progression free survival and overall survival in stage II and III colon cancer.Conclusions 1 The ct EMVI has a strong consistency.It is not cause the assessment of the larger identification and diagnostic errors,with a good feasibility.2 The ct EMVI is independent of TN staging of the prognostic risk factors,ct EMVI in patients with poor prognosis than negative patients.3 The ct EMVI of the positive group of 3-year diseasefree survival and overall survival in stage II colorectal cancer is same as stage III colorectal cancer of negative group.The ct EMVI of positive after radical surgery give adjuvant chemotherapy could have a good clinical benefits in pathological diagnosis of stage II colorectal cancer.The ct EMVI may be a risk factors in stage II colon cancer after radical surgery to give adjuvant chemotherapy.