Objective To explore the predictive value of extracellular volume fraction(ECV)derived from multi-phase contrast-enhanced CT for the prognostic risk of stage Ⅲ colon cancer.Methods The basic data of 55 patients who were diagnosed with stage Ⅲ colon cancer and underwent radical resection at the China-Japan Union Hospital of Jilin University from December 2016 to October 2018 were retrospectively collected.All patients underwent multi-phase-enhanced CT scanning before surgery,and the ECV fraction were calculated by measuring the CT values of the colon cancer lesions and the large arteries at the same level on the plain scan and delayed-phase-enhanced CT images.Patients were divided into high/low ECV groups based on the best cut-off value obtained from the time-dependent ROC curve.The relationship between ECV fraction and recurrent metastasis after surgery for stage Ⅲ colon cancer was as-sessed by COX regression analysis,and the difference in disease-free survival between the high/low ECV groups was compared using Kaplan-Meier curves.In addition pathological ECV fraction were measured on histological sections(H&E staining)to assess the correlation between CT-derived ECV fraction and pathological ECV fraction.Results There were no significant differences in baseline clinical and pathological characteristics between the low and high ECV groups.The 3-year disease-free survival(DFS)rate was significantly higher in the low ECV group(80％)compared to the high ECV group(50％)(P=0.008).Cox regression analysis indicated that ECV fraction is an independent prognos-tic risk factor for stage Ⅲ colon cancer(HR,4.749;95％CI:1.654～13.638;P=0.004).Moreover,there was a signif-icant correlation between CT-derived ECV fraction and pathological ECV fraction(P=0.001,r=0.73).Conclusion Preoperative ECV fraction based on multiphase enhanced CT can serve as an imaging predictor of prognostic survival in stage Ⅲ colon cancer.
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