Prognostic importance of superior diaphragmatic adenopathy at computed tomography in patients with resectable hepatic metastases from colorectal carcinoma

• Published in: Journal of computer assisted tomography Vol. 32; no. 2; pp. 173 - 177
• Main Authors: Aslam, Rizwan, Coakley, Fergus V, Williams, Gethin, Yeh, Benjamin M, Joe, Bonnie N, Zuraek, Marlene B, Warren, Robert S
• Format: Journal Article
• Language: English
• Published: United States 01-03-2008
• Subjects: Adult; Aged; Aged, 80 and over; Colorectal Neoplasms - pathology; Contrast Media - administration & dosage; Female; Humans; Image Processing, Computer-Assisted; Iohexol; Liver - diagnostic imaging; Liver - surgery; Liver Neoplasms - diagnosis; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Middle Aged; Prognosis; Radiographic Image Enhancement - methods; Retrospective Studies; Survival Analysis; Time Factors; Tomography, Spiral Computed - methods
• ISSN: 0363-8715
• DOI: 10.1097/RCT.0b013e3181570370

To determine the prognostic importance of superior diaphragmatic adenopathy at CT in patients with resectable hepatic metastases from colorectal carcinoma.
We retrospectively identified 85 patients who underwent contrast-enhanced abdominal computed tomography (CT) at our institution before surgical resection of hepatic metastases from colorectal carcinoma. The study group consisted of 45 men and 40 women with a mean age of 60 years (range, 27-89 years). The presence, size, and number of superior diaphragmatic nodes were recorded on preoperative CT images. Kaplan-Meier analysis was used to investigate the association between the presence, number, and size of superior diaphragmatic nodes and postoperative outcome.
One or more superior diaphragmatic nodes were seen on preoperative CT in 43 (51%) of 85 patients, and 29 (34%) patients had nodes of 5 mm or more in short-axis diameter. After a median follow-up of 599 days (range, 3-1960 days), 49 patients were alive, and 36 were dead. Kaplan-Meier analysis showed no association between the presence (P = 0.67), size (P = 0.74), or number (P = 0.95) of superior diaphragmatic nodes and patient outcome.
The presence, size, or number of superior diaphragmatic nodes at preoperative CT are unrelated to postoperative outcome in patients with resectable hepatic metastases from colorectal carcinoma, suggesting that superior diaphragmatic adenopathy in this setting may be reactive rather than metastatic.