Preoperative T staging of gastric cancer by multi-detector row computed tomography

Tomoki Makino, Yoshiyuki Fujiwara, Shuji Takiguchi, Takahiro Tsuboyama, Tonsok Kim, Youichirou Nushijima, Makoto Yamasaki, Hiroshi Miyata, Kiyokazu Nakajima, Masaki Mori, Yuichiro Doki

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Abstract

Background and Purpose: Preoperative T staging demands high accuracy, because it greatly influences subsequent therapies in advanced gastric cancer. Patients and Methods: 616 patients with gastric cancer underwent multi-detector row computed tomography (MDCT) before operation. The results were compared with operative and pathologic findings. Especially, we evaluated the correlations among the diagnostic accuracy of T staging and various clinicopathologic parameters by focusing on 276 patients who had detectable lesions by MDCT. Results: The overall diagnostic accuracy of preoperative T staging by MDCT was 90.9% (560/616). For each pathologic T stage, the accuracy was 95% for pT1, 76% for pT2-3, 92% for pT4a, and 75% for pT4b, respectively. Among the 276 patients, 239 (87%) were correctly staged by MDCT whereas 29 (11%) and 8 (3%) were over- or under-staged, respectively. Antral tumors (P = .045), and Borrmann type 1 tumors (P = .0001) were incorrectly T staged by MDCT, whereas differentiated type tumors tended to be over-staged. All patients with positive cytology (n = 12 cases) and peritoneal metastasis (n = 7 cases) diagnosed at laparotomy had been diagnosed as T4a or deeper by MDCT. The 5-year overall survival rates classified by preoperative T staging by MDCT (T1/T2-3/T4a/T4b) were 100%, 89%, 59%, and 31%, respectively, whereas those for each pT stage were 100%, 84%, 59%, and 19%. Conclusion: Preoperative T staging of gastric cancer by MDCT is highly accurate and could contribute to treatment strategies, particularly in advanced disease.

Original languageEnglish
Pages (from-to)672-679
Number of pages8
JournalSurgery
Volume149
Issue number5
DOIs
Publication statusPublished - May 1 2011
Externally publishedYes

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Stomach Neoplasms
Tomography
Neoplasms
Laparotomy
Cell Biology
Survival Rate
Neoplasm Metastasis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Makino, T., Fujiwara, Y., Takiguchi, S., Tsuboyama, T., Kim, T., Nushijima, Y., ... Doki, Y. (2011). Preoperative T staging of gastric cancer by multi-detector row computed tomography. Surgery, 149(5), 672-679. https://doi.org/10.1016/j.surg.2010.12.003

Preoperative T staging of gastric cancer by multi-detector row computed tomography. / Makino, Tomoki; Fujiwara, Yoshiyuki; Takiguchi, Shuji; Tsuboyama, Takahiro; Kim, Tonsok; Nushijima, Youichirou; Yamasaki, Makoto; Miyata, Hiroshi; Nakajima, Kiyokazu; Mori, Masaki; Doki, Yuichiro.

In: Surgery, Vol. 149, No. 5, 01.05.2011, p. 672-679.

Research output: Contribution to journalArticle

Makino, T, Fujiwara, Y, Takiguchi, S, Tsuboyama, T, Kim, T, Nushijima, Y, Yamasaki, M, Miyata, H, Nakajima, K, Mori, M & Doki, Y 2011, 'Preoperative T staging of gastric cancer by multi-detector row computed tomography', Surgery, vol. 149, no. 5, pp. 672-679. https://doi.org/10.1016/j.surg.2010.12.003
Makino T, Fujiwara Y, Takiguchi S, Tsuboyama T, Kim T, Nushijima Y et al. Preoperative T staging of gastric cancer by multi-detector row computed tomography. Surgery. 2011 May 1;149(5):672-679. https://doi.org/10.1016/j.surg.2010.12.003
Makino, Tomoki ; Fujiwara, Yoshiyuki ; Takiguchi, Shuji ; Tsuboyama, Takahiro ; Kim, Tonsok ; Nushijima, Youichirou ; Yamasaki, Makoto ; Miyata, Hiroshi ; Nakajima, Kiyokazu ; Mori, Masaki ; Doki, Yuichiro. / Preoperative T staging of gastric cancer by multi-detector row computed tomography. In: Surgery. 2011 ; Vol. 149, No. 5. pp. 672-679.
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AU - Kim, Tonsok

AU - Nushijima, Youichirou

AU - Yamasaki, Makoto

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AU - Doki, Yuichiro

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N2 - Background and Purpose: Preoperative T staging demands high accuracy, because it greatly influences subsequent therapies in advanced gastric cancer. Patients and Methods: 616 patients with gastric cancer underwent multi-detector row computed tomography (MDCT) before operation. The results were compared with operative and pathologic findings. Especially, we evaluated the correlations among the diagnostic accuracy of T staging and various clinicopathologic parameters by focusing on 276 patients who had detectable lesions by MDCT. Results: The overall diagnostic accuracy of preoperative T staging by MDCT was 90.9% (560/616). For each pathologic T stage, the accuracy was 95% for pT1, 76% for pT2-3, 92% for pT4a, and 75% for pT4b, respectively. Among the 276 patients, 239 (87%) were correctly staged by MDCT whereas 29 (11%) and 8 (3%) were over- or under-staged, respectively. Antral tumors (P = .045), and Borrmann type 1 tumors (P = .0001) were incorrectly T staged by MDCT, whereas differentiated type tumors tended to be over-staged. All patients with positive cytology (n = 12 cases) and peritoneal metastasis (n = 7 cases) diagnosed at laparotomy had been diagnosed as T4a or deeper by MDCT. The 5-year overall survival rates classified by preoperative T staging by MDCT (T1/T2-3/T4a/T4b) were 100%, 89%, 59%, and 31%, respectively, whereas those for each pT stage were 100%, 84%, 59%, and 19%. Conclusion: Preoperative T staging of gastric cancer by MDCT is highly accurate and could contribute to treatment strategies, particularly in advanced disease.

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