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Clinical Medicine: Oncology

Synopsis: An open access, peer reviewed electronic journal that covers cancer research and treatment.


Indexing: 5 major databases. Pubmed indexing for NIH-funded research.

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Journal: 124455
Most read article: 1553
Editor in chief:
William C S Cho
ISSN: 1177-9314


 
 
 


Gastric Adenocarcinoma: Is Computed Tomography (CT) Useful in Preoperative Staging?

Authors: Esther Uña Cidón and Isabel Jiménez Cuenca
Publication Date: 12 Aug 2009
Clinical Medicine: Oncology 2009:3 91-97

Esther Uña Cidón1 and Isabel Jiménez Cuenca2

1Department of Medical Oncology, Clinical University Hospital, s/n C/Ramón y Cajal, 47005 Valladolid, Spain. 2Department of Radiology, Clinical University Hospital, s/n C/Ramón y Cajal, 47005 Valladolid, Spain.  

Abstract

Background and Purpose: Although multiple studies testing the accuracy of CT in the preoperative staging of gastric adenocarcinoma have been carried out, their results are controversial. Whilst some authors claim that CT is an accurate method for preoperatively staging gastric cancer, others have advocated the contrary. Because of this discrepancy we have retrospectively reviewed preoperative CT findings compared with histopathological results in patients with gastric adenocarcinoma.

Patients and Methods: Seventy-two patients diagnosed with gastric cancer who underwent potentially curative surgery and preoperative staging CT of quality were included in the study. The size, gastric wall thickening, presence of lymphadenopathy, adjacent organ invasion and location of the gastric mass was recorded. Early tumors (T1 and T2) and more advanced tumors (T3 and T4) were grouped together. CT staging was correlated with the final histopathological stage (TNM). The global results were expressed as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Results: Seventy-two cases were included with fifty-five being male and a median age of 67 years (range 33–91). CT correctly identified the location of the tumor in 56 (53% antropyloric, 18% subcardial). Median time from CT scan to surgery was fourteen days (range 2–49). In T detection: T1/T2 and T3/T4 with sensitivity of 70% and 61%. Lymph node involvement: Sensitivity 49%. Overstaged in 47% Understaged in 75%. Specificity of 53%. Nine patients with colon-mesocolon (5 patients) and pancreas (4 patients) invasion. Sensitivity 44% and specificity 96%.

Conclusion: Spiral CT is not an accurate method in predicting preoperative stages in gastric cancer.

Categories: Gastroenterology , Oncology


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