Assessment of the Use of Preoperative CT Scan Image for Predicting Lymph Nodes for Resection of Colorectal Cancer: A Retrospective Study

Abstract

<b><i>Introduction:</i></b> Colorectal cancer (CRC) is the most common cancer that accounts for nearly 10% of the cancers, with 1.36 million people worldwide. Nodal status (N-stage) evaluation was inferior between observers, which considered CT scanning a good N-stage. We hypothesized that CRC patients’ preoperative CT scan imaging predicts the nodal and metastatic stage. <b><i>Methods:</i></b> This noninterventional retrospective study was carried out using patients’ medical records, including medical history and results of diagnostic tests, and preoperative clinical and pathological stages. All direct identifiers have been removed from all patient data. This study included 96 patients who underwent resection curative surgery for CRC at the Tertiary Hospital, Sudan, between March 2009 and December 2020. <b><i>Results:</i></b> The median age was 69 years (47–74 years), and 49 (51.04%) were female. The tumor stage of the patients was 4, 11, 74, and 7 as T1, T2, T3, and T4, respectively. A total of 38 patients with a malignant spread in lymph nodes were observed, and the median lymph node count was 11 (range 4–52). Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value (PPV), negative predictive value (NPV), and accuracy calculated for the malignant lymph nodes were 75.56% (95% CI: 60.46–87.12%), 45.10% (95% CI: 31.13–59.66%), 1.38 (95% CI: 1.02–1.86), 0.54 (95% CI: 0.30–0.98), 54.84% (95% CI: 47.38–62.09%), 67.65% (95% CI: 53.53–79.15%), and 59.38% (95% CI: 48.87–69.29%), respectively. <b><i>Conclusion:</i></b> The preoperative CT scan images were used to predict lymph nodes with a diagnostic accuracy of 59.38% for N-stage in patients with CRC.