Grupo Fleury, R. Cincinato Braga 282, São Paulo, SP, 01333-910, Brazil.
Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), R. Botucatu, 740, São Paulo, SP, 04023-062, Brazil.
Abdom Radiol (NY). 2024 Nov;49(11):4003-4015. doi: 10.1007/s00261-024-04373-x. Epub 2024 Jun 4.
Colorectal cancer (CRC) is a significant global health concern. Prognostication of CRC traditionally relies on the Union for International Cancer Control (UICC) and American Joint Committee on Cancer (AJCC) TNM staging classifications, yet clinical outcomes often vary independently of stage. Despite similarities, rectal and colon cancers are distinct in their diagnostic methodologies and treatments, with MRI and CT scans primarily used for staging rectal and colon cancers, respectively. This paper examines the challenges in accurately assessing prognostic factors of colon cancer such as primary tumor extramural extension, retroperitoneal surgical margin (RSM) involvement, extramural vessel invasion (EMVI), and lymph node metastases through preoperative CT and MRI. It highlights the importance of these factors in risk stratification, treatment decisions, and surgical planning for colon cancer patients. Advancements in imaging techniques are crucial for improving clinical management and optimizing patient outcomes, underscoring the necessity for ongoing research to refine diagnostic methods and incorporate novel findings into practice.
结直肠癌（CRC）是一个重大的全球健康问题。CRC 的预后传统上依赖于国际癌症控制联盟（UICC）和美国癌症联合委员会（AJCC）的 TNM 分期分类，但临床结果往往与分期无关。尽管有相似之处，但直肠和结肠癌在诊断方法和治疗上是不同的，MRI 和 CT 扫描分别主要用于直肠和结肠癌的分期。本文探讨了通过术前 CT 和 MRI 准确评估结肠癌预后因素（如原发肿瘤壁外扩展、腹膜后手术切缘（RSM）受累、壁外血管侵犯（EMVI）和淋巴结转移）的挑战。它强调了这些因素在风险分层、治疗决策和结肠癌患者手术计划中的重要性。影像学技术的进步对于改善临床管理和优化患者结局至关重要，这突显了持续研究以完善诊断方法并将新发现纳入实践的必要性。
