Multidetector Computed Tomography Tumour Size Metrics as Predictors of Lymph Node Involvement in Operable Colorectal Cancer

Colorectal cancer (CRC) remains a significant global health burden. This study investigates the relationship between tumor size measured by multidetector computed tomography (MDCT) and regional lymph node metastasis (LNM) in CRC patients. This prospective observational cohort study was conducted at a tertiary care teaching hospital in India from January 2023 to May 2024. Patients with histopathological confirmed CRC who underwent MDCT scanning and subsequent surgical resection were included. Tumor dimensions (length, area, and volume) were measured using MDCT, and correlations with LNM and N stages were analyzed. Fifty-seven patients were included (mean age 59.21 ± 11.6 years, 57.9% male). The sigmoid colon (26.3%) and rectum (22.8%) were the most common tumor locations. Adenocarcinoma was the predominant histological type (78.9%). Positive lymph nodes were found in 56.1% of patients. No statistically significant differences were observed in tumor dimensions between patients with positive and negative lymph nodes or across different N stages. Only Tumor length significantly correlated with the number of harvested lymph nodes. This study reveals a complex relationship between tumor size and lymph node metastasis in colorectal cancer. Although tumor size measured by MDCT did not strongly correlate with LNM, it remains critical for surgical planning, as evidenced by the association between tumor length and lymph node yield. A multidisciplinary approach incorporating various clinical and pathological factors is crucial for accurate staging and optimizing patient-specific treatment strategies in CRC management.