Computed tomographic evaluation and staging of cecal carcinoma

The preoperative computed tomographic (CT) scans of 14 patients with biopsy-proven primary adenocarcinoma of the cecum were reviewed to assess clinical presentation, CT findings, and value of staging by CT. The correlation of CT evidence for tumor invasion beyond the bowel wall with histopathology had predictive value of negative examination of 33% with sensitivity of 78%. More importantly, the correlation of metastatic nodal involvement by CT had predictive value of negative examination of 22% with sensitivity of only 12%. Of chief concern was the involvement of pericolic and mesenteric nodal chains that were not discernible by CT. Computed tomographic tumor staging was accurate in 57% of cases and upgraded in 43%. This study concludes that, although predictive values of positive CT examination are high, CT tends to underestimate disease extent.