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- Title
High Yield of Chest X-ray in the Follow-Up of Colorectal Cancer.
- Authors
Steenhuis, Eline G. M.; Schoenaker, Ivonne J. H.; De Groot, Jan Willem B.; Stigt, Jos A.; Reerink, Onne; De Vos tot Nederveen Cappel, Wouter H.; Van Westreenen, Henderik L.; Brohet, Richard M.
- Abstract
Purpose: Worldwide, colorectal carcinoma (CRC) has a high incidence and a substantial cancer-related mortality. The recurrence risk is 30–50% and lung metastases are common. Treatment of lung metastases with stereotactic ablative radiotherapy (SABR) or metastasectomy may increase survival. The best modality for thoracic screening in the follow-up, however, remains controversial. In this study, we aimed to unravel the additional value of routine chest X-ray (CXR) for detecting lung metastases during the follow-up of CRC patients treated with curative surgery. Methods: Between 2013 and 2017, 668 CRC patients were treated with curative intent, of whom 633 patients were included in follow-up, which consisted of CXR, serum Carcino-Embryonic Antigen (CEA) and ultrasound of the liver. Patients who developed lung metastases, diagnosed with CXR and characterised by a normal concomitant serum CEA level, were identified. Number, size and treatment of lung metastases were described. Results: Thirty-four (5.4%) patients developed lung metastases. Seventeen (50%) were detected by CXR without pathological CEA levels. Eleven (65%) of these patients were treated with curative intent, whereas 21% of patients with lung metastases and elevated CEA levels were treated with curative intent (p = 0.049). Higher numbers of lung metastases were associated with a lower chance of curative treatment. Conclusions: More than 50% of patients with lung metastases on CXR in the follow-up would not have been detected with CEA-triggered imaging only. In addition, patients with colorectal lung metastases without elevated CEA levels were often suitable for curative treatment and, therefore, CXR seems to have additional value within the follow-up of CRC.
- Subjects
COLORECTAL cancer; STEREOTACTIC radiotherapy; X-rays; CANCER-related mortality; CHEST X rays
- Publication
Journal of Clinical Medicine, 2022, Vol 11, Issue 13, p3828
- ISSN
2077-0383
- Publication type
Article
- DOI
10.3390/jcm11133828