Faria Silvana C, Tamm Eric P, Varavithya Vithya, Phongkitkarun Sith, Kaur Harmeet, Szklaruk Janio, Dubrow Ronelle, Charnsangavej Chusilp
Department of Diagnostic Radiology, Division of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Department of Diagnostic Radiology, 1515 Holcombe Blvd., Box 57, Houston, TX 77030, USA.
Eur J Radiol. 2005 Mar;53(3):387-96. doi: 10.1016/j.ejrad.2004.12.018.
Recurrent disease in colorectal cancer occurs in approximately 50% of patients who undergo a "curative" operation. Tumor recurrence may occur locally (at the anastomotic site), in the mesentery or mesocolon adjacent to the post-operative site, in the nodal echelon downstream to the post-operative site, and as distant metastases to the peritoneal cavity, liver or lung. Local recurrence at the anastomosis is frequently diagnosed at follow-up endoscopic examinations as part of screening for metachronous lesions. Other types of recurrences require imaging studies, most frequently CT or MR imaging to diagnose. We developed an approach to analyze imaging obtained after curative resection of colorectal cancer. Our approach is based on the knowledge of patterns of disease spread, of types of surgical procedures and of pathologic staging. Using this approach has the potential to detect recurrent disease at an early stage because the locoregional and nodal spread of this disease is predictable. Early diagnosis of recurrent disease, even in asymptomatic cases, allows for more effective treatment that can improve the long-term survival of these patients.
在接受“根治性”手术的结直肠癌患者中，约50%会出现疾病复发。肿瘤复发可能发生在局部（吻合口处）、术后部位相邻的肠系膜或结肠系膜、术后部位下游的淋巴结区域，以及作为远处转移至腹腔、肝脏或肺部。吻合口处的局部复发常在随访内镜检查时被诊断出来，作为异时性病变筛查的一部分。其他类型的复发则需要影像学检查，最常用的是CT或MR成像来进行诊断。我们开发了一种方法来分析结直肠癌根治性切除术后获得的影像。我们的方法基于对疾病传播模式、手术方式类型和病理分期的了解。使用这种方法有可能在疾病早期检测到复发，因为这种疾病的局部区域和淋巴结扩散是可预测的。即使在无症状的情况下，对复发性疾病的早期诊断也能实现更有效的治疗，从而提高这些患者的长期生存率。
