Review
Copyright ©The Author(s) 2018.
World J Gastrointest Oncol. Oct 15, 2018; 10(10): 293-316
Published online Oct 15, 2018. doi: 10.4251/wjgo.v10.i10.293
Table 1 Diagnostic evaluation of synchronous colorectal cancer
Local tumour staging Preoperative colonoscopy with histological assessment of all colorectal lesions CT of the abdomen and pelvis
In case of rectal cancer include Endorectal ultrasound Pelvic magnetic resonance imaging
If preoperative evaluation during colonoscopy is incomplete (bowel obstruction, poor bowel preparation, technical reasons, etc.) Double-contrast barium enema CT colonography, if available MRI colonography, if available PET–CT colonography, if available
Intraoperative assessment Intraoperative colonoscopy Palpation of the entire colon Thorough examination of pathological specimens
Evaluation of metastatic disease CT of the chest, abdomen, and pelvis MRI of the chest, abdomen, and pelvis, in selected cases 18FDG-PET–CT, in selected cases
Patient performance status Thorough evaluation of coexisting morbidities Pulmonary function tests, in selected cases Echocardiography, in selected cases
CT: Computer tomography; MRI: Magnetic resonance imaging; PET-CT: Positron emission tomography/computer tomography.
Table 2 Diagnostic evaluation of synchronous colorectal liver metastases
Local tumour staging CT and/or MRI of the liver, to evaluate Number and location of CRLM Tumour-vessels relationship Pattern of the hepatic vasculature Presence of anatomical variations Future remnant liver volumes
Intraoperative assessment Intraoperative ultrasonography
Evaluation of metastatic disease CT of the chest, abdomen, and pelvis MRI of the chest, abdomen, and pelvis, in selected cases 18FDG-PET–CT
Patient performance status Thorough evaluation of coexisting morbidities Pulmonary function tests Echocardiography
In the case of suspected liver disease/steatosis include (elderly patients, metabolic syndrome, previous systemic CHT, etc.) Liver function tests Evaluation of the grade of steatosis, in selected cases
CT: Computer tomography; CRLM: Colorectal cancer and synchronous liver metastases; CHT: Chemotherapy; MRI: Magnetic resonance imaging; PET-CT: Positron emission tomography/computer tomography.