Skip to main content

Advertisement

SpringerLink
Log in

The prognostic significance of extramural venous invasion detected by multiple-row detector computed tomography in stage III gastric cancer

  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To determine the 1-year progression-free survival (PFS) of extramural venous invasion (EMVI), detected with contrast-enhanced multiple-row detector computed tomography (ceMDCT), in patients with stage III gastric cancer.

Methods

Between January 2009 and December 2013, 117 patients with pathological-proved stage III gastric cancer based on the criteria of the AJCC 7th were included in this retrospective study. All patients underwent adjuvant chemotherapy postoperatively and had been monitored with the follow-up chest/abdomen/pelvis ceMDCT on 3, 6, and 12 months post-operation. Two radiologists reviewed preoperative images regarding the presence of EMVI, categories of tumor and categories of lymph node. Conventional prognostic histological factors including pathological T/N status, tumor location/growth pattern, histological type/tumor differentiation, and tumor size were also recorded. Disease progression was defined as the presence of radiological or/and pathology-confirmed metachronous metastases, local recurrence, or gastric cancer-related death. The 1-year PFS for both EMVI-positive and EMVI-negative was calculated using the Kaplan–Meier product limit. Hazard ratios for 1-year PFS were generated using a Cox proportional hazard regression on ceMDCT tumor characteristics.

Results

The prevalence of EMVI detected with ceMDCT was 43.6% (51/117) in patients with stage III gastric cancer. The EMVI-positive patients had significantly lower 1-year PFS rates (45.1%), than the EMVI-negative patients (75.8%), (Log-rank test, P = 0.0008). In a Cox proportional hazards regression analysis, EMVI and tumor location/growth pattern were identified as independent prognostic factors of 1-year PFS with hazard ratio of 2.272 (95% CI 1.133–4.556, P = 0.021) and 1.982 (95% CI 1.040–3.780, P = 0.039), respectively.

Conclusion

EMVI status, detected with ceMDCT, could be used to counsel patients regarding ongoing risks of metastatic disease, implications for surveillance, and systemic chemotherapy.

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
Fig. 4

Similar content being viewed by others

References

  1. Sasako M, Inoue M, Lin JT, et al. (2010) Gastric Cancer Working Group report. Jpn J Clin Oncol 40(Suppl 1):i28–i37

    Article  PubMed  Google Scholar 

  2. Jemal A, Siegel R, Xu J, et al. (2010) Cancer statistics, 2010. CA Cancer J Clin 60(5):277–300

    Article  PubMed  Google Scholar 

  3. Sadeghi B, Arvieux C, Glehen O, et al. (2000) Peritoneal carcinomatosis from non-gynecologic malignancies: results of the EVOCAPE 1 multicentric prospective study. Cancer 88(2):358–363

    Article  CAS  PubMed  Google Scholar 

  4. Edge SB, Compton CC (2010) The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17(6):1471–1474

    Article  PubMed  Google Scholar 

  5. Rivera F, Vega-Villegas ME, Lopez-Brea MF (2007) Chemotherapy of advanced gastric cancer. Cancer Treat Rev 33(4):315–324

    Article  CAS  PubMed  Google Scholar 

  6. Kim JW, Shin SS, Heo SH, et al. (2015) The role of three-dimensional multidetector CT gastrography in the preoperative imaging of stomach cancer: emphasis on detection and localization of the tumor. Korean J Radiol 16(1):80–89

    Article  PubMed  PubMed Central  Google Scholar 

  7. Allum WH, Griffin SM, Watson A, et al. (2002) Guidelines for the management of oesophageal and gastric cancer. Gut 50(Suppl 5):v1–v23

    Article  PubMed  PubMed Central  Google Scholar 

  8. Hunter CJ, Garant A, Vuong T, et al. (2012) Adverse features on rectal MRI identify a high-risk group that may benefit from more intensive preoperative staging and treatment. Ann Surg Oncol 19(4):1199–1205

    Article  PubMed  Google Scholar 

  9. Grigoryeva ES, Cherdyntseva NV, Karbyshev MS, et al. (2013) Expression of cyclophilin A in gastric adenocarcinoma patients and its inverse association with local relapses and distant metastasis. Pathol Oncol Res 20(2):467–473

    Article  PubMed  Google Scholar 

  10. Tan CH, Vikram R, Boonsirikamchai P, et al. (2011) Extramural venous invasion by gastrointestinal malignancies: CT appearances. Abdom Imaging 36(5):491–502

    Article  PubMed  Google Scholar 

  11. Zurleni T, Gjoni E, Ballabio A, et al. (2013) Sixth and seventh tumor-node-metastasis staging system compared in gastric cancer patients. World J Gastrointest Surg 5(11):287–293

    Article  PubMed  PubMed Central  Google Scholar 

  12. Foo M, Leong T (2014) Adjuvant therapy for gastric cancer: current and future directions. World J Gastroenterol 20(38):13718–13727

    Article  PubMed  PubMed Central  Google Scholar 

  13. Kim JW, Shin SS, Heo SH, et al. (2012) Diagnostic performance of 64-section CT using CT gastrography in preoperative T staging of gastric cancer according to 7th edition of AJCC cancer staging manual. Eur Radiol 22(3):654–662

    Article  PubMed  Google Scholar 

  14. Seevaratnam R, Cardoso R, McGregor C, et al. (2012) How useful is preoperative imaging for tumor, node, metastasis (TNM) staging of gastric cancer? A meta-analysis. Gastric Cancer 15(Suppl 1):S3–S18

    Article  PubMed  Google Scholar 

  15. Shah MA, Khanin R, Tang L, et al. (2011) Molecular classification of gastric cancer: a new paradigm. Clin Cancer Res 17(9):2693–2701

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174

    Article  CAS  PubMed  Google Scholar 

  17. Castonguay MC, Li-Chang HH, Driman DK (2014) Venous invasion in oesophageal adenocarcinoma: enhanced detection using elastic stain and association with adverse histological features and clinical outcomes. Histopathology 64(5):693–700

    Article  PubMed  Google Scholar 

  18. Inada K, Shimokawa K, Ikeda T, et al. (1990) The clinical significance of venous invasion in cancer of the stomach. Jpn J Surg 20(5):545–552

    Article  CAS  PubMed  Google Scholar 

  19. Bugg WG, Andreou AK, Biswas D, et al. (2014) The prognostic significance of MRI-detected extramural venous invasion in rectal carcinoma. Clin Radiol 69(6):619–623

    Article  CAS  PubMed  Google Scholar 

  20. Betge J, Pollheimer MJ, Lindtner RA, et al. (2012) Intramural and extramural vascular invasion in colorectal cancer: prognostic significance and quality of pathology reporting. Cancer 118(3):628–638

    Article  PubMed  Google Scholar 

  21. Chand M, Bhangu A, Wotherspoon A, et al. (2014) EMVI-positive stage II rectal cancer has similar clinical outcomes as stage III disease following pre-operative chemoradiotherapy. Ann Oncol 25(4):858–863

    Article  CAS  PubMed  Google Scholar 

  22. Crosby T (2008) Scottish Intercollegiate Guidelines Network (SIGN) 87–the management of oesophageal and gastric cancer. Clin Oncol (R Coll Radiol) 20(7):528–529

    Article  CAS  Google Scholar 

  23. Sternberg A, Amar M, Alfici R, et al. (2002) Conclusions from a study of venous invasion in stage IV colorectal adenocarcinoma. J Clin Pathol 55(1):17–21

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Peking University People’s Hospital, 11 Xizhimen South St., Beijing, 100044, China

    Jin Cheng, Jing Wu & Yi Wang

  2. Department of Gastrointestinal Surgery, Peking University People’s Hospital, 11 Xizhimen South St., Beijing, 100044, China

    Yingjiang Ye

  3. Clinical Epidemiology and Medical Statistics, Peking University People’s Hospital, 11 Xizhimen South St., Beijing, 100044, China

    Chunfang Zhang

  4. Department of Pathology, Peking University People’s Hospital, 11 Xizhimen South St., Beijing, 100044, China

    Yinli Zhang

Authors
  1. Jin Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jing Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yingjiang Ye
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chunfang Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Yinli Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yi Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yi Wang.

Ethics declarations

Conflict of interest

All of authors have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cheng, J., Wu, J., Ye, Y. et al. The prognostic significance of extramural venous invasion detected by multiple-row detector computed tomography in stage III gastric cancer. Abdom Radiol 41, 1219–1226 (2016). https://doi.org/10.1007/s00261-015-0627-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-015-0627-1

Keywords

Search

Navigation