Clinical usefulness of chest radiography in detection of pulmonary metastases after curative resection for colorectal cancer

Purpose: The purpose of this study was to evaluate the effectiveness of chest radiography (CXR) and abdominal computed tomography (CT) for detecting pulmonary metastases after curative surgery for colorectal cancer. Methods: We performed a retrospective analysis of the records of all patients with pulmonary metastasis from colorectal cancer who underwent curative resection between 1994 and 2004 at our institution. Results: Pulmonary metastases were detected in 193 patients by either CXR or abdominal CT. They were initially detected by CXR in 87 patients (45.1%) and by abdominal CT in 106 patients (54.9%). In the CXR group, the patterns of pulmonary recurrence were as follows: solitary (n = 38, 43.7%), multiple unilateral (n = 11, 12.6%), and multiple bilateral (n = 38, 43.7%). In the CT group, there were 22 patients (20.8%) with a solitary nodule, 17 patients (16.0%) with multiple unilateral nodules, and 67 (63.2%) with multiple bilateral nodules. The overall survivals of the CXR group and abdominal CT group were 34.6% and 31.7%, respectively (p = 0.312). There was no difference in the median disease-free interval between the CXR group and the abdominal CT group (23.8 vs. 23.2 months, p = 0.428). Conclusions: Although this study is limited by its small sample size, it can be speculated that abdominal CT with lower thorax images may replace CXR in surveillance programs.