Preoperative CT Nodal Staging Versus Pathology in Colon Cancer: A Retrospective Multicentre Diagnostic Accuracy Study

Abstract

Simple Summary Computed tomography is used before colon cancer surgery to assess whether cancer has spread to nearby lymph nodes. This information may influence treatment discussions, but scan findings do not always match examination of the removed tissue. We compared routine scan-based nodal classifications with surgical pathology in 590 patients treated at five Polish centres. About one in five patients whose scans suggested no nodal involvement had cancer-positive nodes at pathology, while about half of those classified as node-positive on scans had no nodal metastases identified after surgery. More advanced primary tumours were associated with hidden nodal disease among patients classified as node-negative. These findings show why lymph node findings on scans should be considered together with other tumour and patient characteristics during multidisciplinary planning. They do not establish a rule for selecting preoperative treatment.