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A Prospective Validation Study to Diagnose Serosal Invasion and Nodal Metastases of Gastric Cancer by Multidetector-row CT

  • Gynecologic Oncology
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Multidetector-row CT (MDCT) may provide accurate preoperative staging of resectable gastric cancer. However, the standard methods and criteria to diagnose the T and N stages to select the patients who are good candidates for neoadjuvant chemotherapy have not been established yet.

Methods

The aim of this prospective study was to evaluate the accuracy of MDCT to diagnose the serosal invasion and nodal metastases of gastric cancer. Patients who had gastric adenocarcinoma underwent MDCT scanning using a standardized method. The T and N stage were diagnosed by prespecified criteria. The analyses were performed in the patients who had cN0–2 and M0 tumors and underwent curative gastrectomy as a primary treatment. The accuracy was calculated by comparing the results of MDCT with the histopathological findings.

Results

A total of 315 patients were analyzed. The overall diagnostic accuracy (95 % confidence interval) of T staging was 71.4 % (225 of 315, 66.2–76.1). The accuracy, sensitivity, and specificity for serosal invasion were 85.7 % (81.4–89.1), 54.5 % (42.6–66.0), and 94.0 % (90.3–96.3), respectively. The false-positive rate for serosal invasion was 6.0 % (2.9–7.7). The overall diagnostic accuracy of N staging was 75.9 % (239 of 315, 70.9–80.3). The accuracy, sensitivity, and specificity for nodal metastases were 81.3 % (76.6–85.2), 46.4 % (36.8–56.3), and 96.8 % (93.5–98.4), respectively. The false-positive rate for nodal metastases was 3.2 % (1.6–6.5 %).

Conclusions

These results suggest that MDCT provides an accurate diagnosis with high specificity and a low false-positive rate and can be used to select the patients who are candidates for preoperative chemotherapy.

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-Ku, Yokohama, 241-0815, Japan

    Shinichi Hasegawa MD, Takaki Yoshikawa MD, PhD, Junya Shirai MD, Hirohito Fujikawa MD, Haruhiko Cho MD & Akira Tsuburaya MD

  2. Department of Radiology, Kanagawa Cancer Center, 1-1-2 Nakao, Asahi-Ku, Yokohama, 241-0815, Japan

    Tsunehiro Doiuchi MD & Tetsuo Yoshida MD

  3. Department of Surgery, Yokohama City University, Yokohama, Japan

    Shinichi Hasegawa MD, Takaki Yoshikawa MD, PhD, Junya Shirai MD, Hirohito Fujikawa MD, Tsutomu Sato MD, Takashi Oshima MD, PhD, Norio Yukawa MD, Yasushi Rino MD & Munetaka Masuda MD, PhD

Authors
  1. Shinichi Hasegawa MD
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  2. Takaki Yoshikawa MD, PhD
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  3. Junya Shirai MD
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  4. Hirohito Fujikawa MD
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  5. Haruhiko Cho MD
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  6. Tsunehiro Doiuchi MD
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  7. Tetsuo Yoshida MD
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  8. Tsutomu Sato MD
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  9. Takashi Oshima MD, PhD
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  10. Norio Yukawa MD
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  11. Yasushi Rino MD
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  12. Munetaka Masuda MD, PhD
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  13. Akira Tsuburaya MD
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Corresponding author

Correspondence to Takaki Yoshikawa MD, PhD.

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Hasegawa, S., Yoshikawa, T., Shirai, J. et al. A Prospective Validation Study to Diagnose Serosal Invasion and Nodal Metastases of Gastric Cancer by Multidetector-row CT. Ann Surg Oncol 20, 2016–2022 (2013). https://doi.org/10.1245/s10434-012-2817-1

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  • DOI: https://doi.org/10.1245/s10434-012-2817-1

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