Clinical Medicine: Oncology
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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.
Keywords: gastric adenocarcinoma, preoperative staging, computed tomography, (CT)
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Dysfunction of Corticomotoneurons in Guillain-Barré Syndrome (GBS)? - 01/Oct/2009
Metabolic Complications of Bypass Surgery for Morbid Obesity - 18/Sep/2009
Asymmetrical Weakness Associated with Central Nervous System Involvement in a Patient with Guillain-Barrè Syndrome - 03/Sep/2009
Modulation of the BRCA1 Protein and Induction of Apoptosis in Triple Negative Breast Cancer Cell Lines by the Polyphenolic Compound Curcumin - 02/Sep/2009
Unblocking Blockbusters: Using Boolean Text-Mining to Optimise Clinical Trial Design and Timeline for Novel Anticancer Drugs - 17/Aug/2009
Growth Factor Receptors and Apoptosis Regulators: Signaling Pathways, Prognosis, Chemosensitivity and Treatment Outcomes of Breast Cancer - 17/Aug/2009
Molecular Imaging of Proteases in Cancer - 17/Aug/2009
New Advanced Technologies to Provide Decentralised and Secure Access to Medical Records: Case Studies in Oncology - 07/Aug/2009
The Bimodality Index: A Criterion for Discovering and Ranking Bimodal Signatures from Cancer Gene Expression Profiling Data - 05/Aug/2009
A Generalized Beta Model for the Age Distribution of Cancers: Application to Pancreatic and Kidney Cancer - 04/Aug/2009
Methotrexate-Induced Acute Leukemia: Report of Three Cases and Review of the Literature - 31/Jul/2009
Sarcomatoid Carcinoma of the Urinary Bladder Treated with Adjuvant Radiotherapy: A Case Report - 30/Jul/2009
Linguistic Processing and Classification of Semi Structured Bibliographic Data on Complementary Medicine - 06/Jul/2009
Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletoe Extract to Chemotherapy Alone - 06/Jul/2009
Dysfunction of Corticomotoneurons in Guillain-Barré Syndrome (GBS)? - 01/Oct/2009
Metabolic Complications of Bypass Surgery for Morbid Obesity - 18/Sep/2009
Asymmetrical Weakness Associated with Central Nervous System Involvement in a Patient with Guillain-Barrè Syndrome - 03/Sep/2009
Modulation of the BRCA1 Protein and Induction of Apoptosis in Triple Negative Breast Cancer Cell Lines by the Polyphenolic Compound Curcumin - 02/Sep/2009
Unblocking Blockbusters: Using Boolean Text-Mining to Optimise Clinical Trial Design and Timeline for Novel Anticancer Drugs - 17/Aug/2009
Growth Factor Receptors and Apoptosis Regulators: Signaling Pathways, Prognosis, Chemosensitivity and Treatment Outcomes of Breast Cancer - 17/Aug/2009
Molecular Imaging of Proteases in Cancer - 17/Aug/2009
New Advanced Technologies to Provide Decentralised and Secure Access to Medical Records: Case Studies in Oncology - 07/Aug/2009
The Bimodality Index: A Criterion for Discovering and Ranking Bimodal Signatures from Cancer Gene Expression Profiling Data - 05/Aug/2009
A Generalized Beta Model for the Age Distribution of Cancers: Application to Pancreatic and Kidney Cancer - 04/Aug/2009
Methotrexate-Induced Acute Leukemia: Report of Three Cases and Review of the Literature - 31/Jul/2009
Sarcomatoid Carcinoma of the Urinary Bladder Treated with Adjuvant Radiotherapy: A Case Report - 30/Jul/2009
Linguistic Processing and Classification of Semi Structured Bibliographic Data on Complementary Medicine - 06/Jul/2009
Quality of Life and Neutropenia in Patients with Early Stage Breast Cancer: A Randomized Pilot Study Comparing Additional Treatment with Mistletoe Extract to Chemotherapy Alone - 06/Jul/2009