Lower GI 2016

The Royal Marsden Measuring size of nodes worsens results – overstaging and overtreatment of low risk patients

• node positive if either irregular border or mixed signal intensity. • Metastases demonstrated in 51/56 nodes (91%, 95% CI 81% to 96%) with either an irregular border or a mixed intensity signal. • only 9/225 nodes (4%, CI 2.1% to 7.4%) with smooth borders and a uniform signal contained metastases irrespective of size. • Size of node bears no relationship to malignant risk Brown et al Radiology 2003