Skip to main content

Advertisement

SpringerLink
Log in

Usefulness of Two-Dimensional Values Measured Using Preoperative Multidetector Computed Tomography in Predicting Lymph Node Metastasis of Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Multidetector computed tomography (MDCT) is essential for the prediction of lymph node (LN) metastasis in gastric cancer. However, the measurement method and size criteria for metastatic LNs using MDCT are unclear.

Methods

MDCTs of gastric cancer patients who underwent surgery and had pathological staging were reviewed by radiologists. The two-dimensional cutoff values for LNs with suspected metastasis were calculated, and clinicopathological data were analyzed using those cutoff values.

Results

The total number of enrolled patients was 327. The cutoff values of the maximal area with metastatic LNs were obtained significantly at stations 3, 4, and 6, and those values were 112.09, 33.79, and 85.88 mm2, respectively. The common cutoff value was 112.09 mm2, and the area under the curve was 0.617 (P = 0.002). The overall survival rate of the patients with LNs less than 112.09 mm2 was significantly better than those with LNs greater than 112.09 mm2 (P < 0.001). In multivariate analysis, the maximal LN area was an independent prognostic factor (adjusted hazard ratio, 1.697 [95% confidence interval 1.116–2.582]).

Conclusions

Using two-dimensional values for LNs measured by MDCT is a practical method of predicting metastatic LNs in gastric cancer. The maximal LN area value would be useful in both the preoperative staging and prognosis prediction of gastric cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Stabile Ianora AA, Pedote P, Scardapane A, Memeo M, Rotondo A, Angelelli G. Preoperative staging of gastric carcinoma with multidetector spiral CT. Radiol Med. 2003;106:467–80.

    PubMed  Google Scholar 

  2. Kwee RM, Kwee TC. Imaging in local staging of gastric cancer: a systematic review. J Clin Oncol. 2007;25:2107–16.

    Article  PubMed  Google Scholar 

  3. Kim AY, Kim HJ, Ha HK. Gastric cancer by multidetector row CT: preoperative staging. Abdom Imaging. 2005;30:465–72.

    Article  PubMed  CAS  Google Scholar 

  4. Chen CY, Wu DC, Kang WY, Hsu JS. Staging of gastric cancer with 16-channel MDCT. Abdom Imaging. 2006;31:514–20.

    Article  PubMed  Google Scholar 

  5. Matsuki M, Kani H, Tatsugami F, et al. Preoperative assessment of vascular anatomy around the stomach by 3D imaging using MDCT before laparoscopy-assisted gastrectomy. AJR Am J Roentgenol. 2004;183:145–51.

    Article  PubMed  Google Scholar 

  6. Pan Z, Zhang H, Yan C, et al. Determining gastric cancer resectability by dynamic MDCT. Eur Radiol. 2010;20:613–20.

    Article  PubMed  Google Scholar 

  7. Yan C, Zhu ZG, Yan M, et al. Value of multidetector-row computed tomography in the preoperative T and N staging of gastric carcinoma: a large-scale Chinese study. J Surg Oncol. 2009;100:205–14.

    Article  PubMed  Google Scholar 

  8. Hur J, Park MS, Lee JH, et al. Diagnostic accuracy of multidetector row computed tomography in T- and N staging of gastric cancer with histopathologic correlation. J Comput Assist Tomogr. 2006;30:372–7.

    Article  PubMed  Google Scholar 

  9. Kwee RM, Kwee TC. Imaging in assessing lymph node status in gastric cancer. Gastric Cancer. 2009;12:6–22.

    Article  PubMed  CAS  Google Scholar 

  10. Anzidei M, Napoli A, Zaccagna F, et al. Diagnostic performance of 64-MDCT and 1.5-T MRI with high-resolution sequences in the T staging of gastric cancer: a comparative analysis with histopathology. Radiol Med. 2009;114:1065–79.

    Article  PubMed  CAS  Google Scholar 

  11. Kim SH, Kim JJ, Lee JS, et al. Preoperative N staging of gastric cancer by stomach protocol computed tomography. J Gastric Cancer. 2013;13:149–56.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Yan C, Zhu ZG, Yan M, et al. Size of the largest lymph node visualized on multi-detector-row computed tomography (MDCT) is useful in predicting metastatic lymph node status of gastric cancer. J Int Med Res. 2010;38:22–33.

    Article  PubMed  CAS  Google Scholar 

  13. Lee MH, Choi D, Park MJ, Lee MW. Gastric cancer: imaging and staging with MDCT based on the 7th AJCC guidelines. Abdom Imaging. 2012;37:531–40.

    Article  PubMed  Google Scholar 

  14. Morgagni P, Petrella E, Basile B, et al. Preoperative multidetector-row computed tomography scan staging for lymphatic gastric cancer spread. World J Surg Oncol. 2012;10:197.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Tokunaga M, Sugisawa N, Tanizawa Y, Bando E, Kawamura T, Terashima M. The impact of preoperative lymph node size on long-term outcome following curative gastrectomy for gastric cancer. Ann Surg Oncol. 2013;20:1598–603.

    Article  PubMed  Google Scholar 

  16. Zhang XP, Wang ZL, Tang L, Sun YS, Cao K, Gao Y. Support vector machine model for diagnosis of lymph node metastasis in gastric cancer with multidetector computed tomography: a preliminary study. BMC Cancer. 2011;11:10.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Park HS, Kim YJ, Ko SY, et al. Benign regional lymph nodes in gastric cancer on multidetector row CT. Acta Radiol. 2012;53:501–7.

    Article  PubMed  Google Scholar 

  18. Buerke B, Puesken M, Muter S, et al. Measurement accuracy and reproducibility of semiautomated metric and volumetric lymph node analysis in MDCT. AJR Am J Roentgenol. 2010;195:979–85.

    Article  PubMed  Google Scholar 

  19. Lee SM, Kim SH, Lee JM, et al. Usefulness of CT volumetry for primary gastric lesions in predicting pathologic response to neoadjuvant chemotherapy in advanced gastric cancer. Abdom Imaging. 2009;34:430–40.

    Article  PubMed  Google Scholar 

  20. Kim YN, Choi D, Kim SH, et al. Gastric cancer staging at isotropic MDCT including coronal and sagittal MPR images: endoscopically diagnosed early vs. advanced gastric cancer. Abdom Imaging. 2009;34:26–34.

    Article  PubMed  Google Scholar 

  21. Lee HH, Yoo HM, Song KY, Jeon HM, Park CH. Risk of limited lymph node dissection in patients with clinically early gastric cancer: indications of extended lymph node dissection for early gastric cancer. Ann Surg Oncol. 2013;20:3534–40.

    Article  PubMed  Google Scholar 

  22. Kinami S, Fujimura T, Ojima E, et al. PTD classification: proposal for a new classification of gastric cancer location based on physiological lymphatic flow. Int J Clin Oncol. 2008;13:320–9.

    Article  PubMed  Google Scholar 

Download references

Acknowledgment

This study was supported by a grant from the National Research Foundation of Korea (No. 2012R1A1A1043576) and Fukuoka Foundation for Sound Health Cancer Research Fund. The statistical consultation was supported by the Catholic Research Coordinating Center of the Korea Health 21 R&D Project (A070001), Ministry of Health & Welfare, Republic of Korea.

Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Su Lim Lee M.D. & Young Mi Ku M.D.

  2. Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Han Hong Lee M.D. & Hae Myung Jeon M.D.

  3. Department of Surgery, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyenggi-Do, Korea

    Han Hong Lee M.D.

Authors
  1. Su Lim Lee M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Han Hong Lee M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Young Mi Ku M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hae Myung Jeon M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Han Hong Lee M.D..

Electronic supplementary material

Below is the link to the electronic supplementary material.

10434_2015_4621_MOESM1_ESM.tif

Supplementary Fig. 1: Overall survival curves of patients with small and large area LNs (P < 0.001). Supplementary material 1 (TIFF 2046 kb)

Supplementary material 2 (DOC 169 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, S.L., Lee, H.H., Ku, Y.M. et al. Usefulness of Two-Dimensional Values Measured Using Preoperative Multidetector Computed Tomography in Predicting Lymph Node Metastasis of Gastric Cancer. Ann Surg Oncol 22 (Suppl 3), 786–793 (2015). https://doi.org/10.1245/s10434-015-4621-1

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-015-4621-1

Keywords

Search

Navigation