{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T19:16:29Z","timestamp":1790882189010,"version":"4.1.0"},"reference-count":38,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Computed tomography (CT) informs preoperative staging in colon cancer, yet its diagnostic accuracy for lymph node involvement relative to pathological staging remains uncertain. We examined nodal concordance and multicentre variation in Poland. Methods: This retrospective diagnostic accuracy study included adults who underwent upfront resection for nonmetastatic colon cancer at five centres between January 2022 and August 2025. All underwent preoperative CT; recorded cN categories were dichotomised as cN0 versus cN+ (any positive cN category), and pathological pN was the reference. We estimated accuracy, sensitivity, specificity, predictive values, and kappa with 95% confidence intervals. A centre-adjusted exploratory analysis examined the association between cT3\u20134 and occult pN+ among cN0 patients. Results: Of 662 otherwise eligible patients, 590 had evaluable cN and pN. CT and pathology agreed in 386 (65.4%; 95% CI, 61.5\u201369.2; \u03ba = 0.276; 95% CI, 0.199\u20130.353). Occult pN+ occurred in 73 of 335 cN0 patients (21.8%; 95% CI, 17.7\u201326.5); 131 of 255 cN+ patients were pN0 (51.4%; 95% CI, 45.3\u201357.4). Sensitivity was 62.9% and specificity 66.7%. Centre-level cN\/pN completeness ranged from 73.5% to 100%. cT3\u20134 was associated with occult pN+ after centre adjustment (OR, 3.10; 95% CI, 1.71\u20135.62). Sensitivity analyses were materially consistent. Conclusions: Routine CT nodal classification showed limited concordance with pathology. The cT3\u20134 association is exploratory and does not establish a prediction or treatment selection rule; cN alone should not determine treatment.<\/jats:p>","DOI":"10.3390\/cancers18193175","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:43:24Z","timestamp":1790880204000},"page":"3175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preoperative CT Nodal Staging Versus Pathology in Colon Cancer: A Retrospective Multicentre Diagnostic Accuracy Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1506-9735","authenticated-orcid":false,"given":"Tomasz","family":"Cwali\u0144ski","sequence":"first","affiliation":[{"name":"Department of General Surgery and Surgical Oncology, Saint Wojciech Hospital, Nicolaus Copernicus Health Center, 80-462 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Mateusz","family":"Jagielski","sequence":"additional","affiliation":[{"name":"Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toru\u0144, 85-067 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8080-3001","authenticated-orcid":false,"given":"Micha\u0142","family":"Kazanowski","sequence":"additional","affiliation":[{"name":"Department of Oncology and Haematology, Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland"},{"name":"First Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Pl. Hirszfelda 12, 53-413 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Jacek","family":"Pi\u0105tkowski","sequence":"additional","affiliation":[{"name":"Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toru\u0144, 85-067 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5935-0633","authenticated-orcid":false,"given":"Maciej","family":"Ciesielski","sequence":"additional","affiliation":[{"name":"Department of Oncological Surgery, Gdynia Oncology Centre, 81-519 Gdynia, Poland"},{"name":"Department of Oncological Surgery, Faculty of Health Sciences with the Institute of Maritime and Tropical Medicine, Medical University of Gda\u0144sk, 81-519 Gdynia, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"}]},{"given":"Marcin","family":"Januszkiewicz","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive and Oncological General Surgery, Voivodeship Hospital in Bialystok, 15-950 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0316-0186","authenticated-orcid":false,"given":"Zuzanna","family":"Bigus","sequence":"additional","affiliation":[{"name":"Department of General Surgery and Surgical Oncology, Saint Wojciech Hospital, Nicolaus Copernicus Health Center, 80-462 Gda\u0144sk, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9359-157X","authenticated-orcid":false,"given":"Patryk","family":"Kaczor","sequence":"additional","affiliation":[{"name":"Department of General, Gastroenterological and Oncological Surgery, Collegium Medicum, Nicolaus Copernicus University in Toru\u0144, 85-067 Bydgoszcz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2894-4834","authenticated-orcid":false,"given":"Bartosz","family":"Kapturkiewicz","sequence":"additional","affiliation":[{"name":"Department of Oncology and Haematology, Faculty of Medicine, Wroclaw University of Science and Technology, 50-370 Wroclaw, Poland"},{"name":"First Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Pl. Hirszfelda 12, 53-413 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6454-4943","authenticated-orcid":false,"given":"Pawe\u0142","family":"Lesiak","sequence":"additional","affiliation":[{"name":"First Department of Surgical Oncology, Lower Silesian Oncology, Pulmonology and Hematology Center, Pl. 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