AB158. 217. A comparison of clinical-radiological and pathological colorectal cancer staging: a 6-year model 3 Irish hospital experience

Abstract: The tumour-node-metastases staging system developed by the American Joint Committee on Cancer (AJCC) and the International Union for Cancer Control (UICC) is the most widely used classification system for colorectal cancer staging. Accurate pre-operative clinical-radiological staging facilitates timely oncological and surgical planning. This study describes a cohort of patients treated for colorectal cancer in a model 3 Irish hospital. We aim to assess the accuracy of pre-operative clinical-radiological staging in a non-specialist centre. A retrospective cohort study examined records patients with histologically confirmed colorectal carcinoma from 2010 to 2015. Data was collected from chart review and prospectively maintained electronic histopathology and radiological databases. Clinical-radiological and pathological stages, as defined by the AJCC Cancer Staging Manual 7th Edition, were compared. A total of 98 colorectal cancer cases managed in our centre were identified. Mean age at presentation was 67.9 years (± SD, 12.1). Fifty percent (n=49/98) were males, 26.5% (n=26/98) had rectal tumours, while 73.5% (n=72/98) had colon cancer. Of these patients, 85.7% (n=84/98) underwent surgery following clinical staging. Clinical-radiological stage differed from pathological stage in 27.4% (n=23/84) of patients (P<0.0001). Of 23 patients where overall stage changed, eight patients were up-staged (none of whom had neoadjuvant therapy), whereas 15 were down-staged (7 of whom did not have neoadjuvant treatment). High quality, accurate clinical-radiological staging enables multi-disciplinary teams to plan optimal management approaches for patients with colorectal neoplasms. Strategies to improve accuracy of clinical-radiological staging minimise patient morbidity and mortality related to the under- and over-treatment of colorectal cancer.

Keywords: Colorectal; cancer; clinical staging; pathological staging