Multiple Detector-Row CT in Gastric Cancer Staging: Prospective Study

Abstract

The aim of this study was to evaluate the accuracy of multiple detector computed tomography (MDCT) in the preoperative staging of gastric cancer, prospectively comparing CT findings with pathological findings at surgery, in a single-center study. A total of 19 consecutive patients with primary cancer recruited between March and July 2014 were submitted to preoperative MDCT staging according to a standard protocol. All diagnostic procedures were performed by dedicated radiologists who were unaware of the final pathological results. Subsequently, 16 patients underwent surgical treatment and 15 were finally included in the study. The primary tumor was detected at CT in all 15 cases. CT results for T staging were in agreement with pathological findings in 12 of 15 cases, with overall accuracy of 80%. Stage-specific sensibility was high for advanced stages (sensibility for T1, T3, and T4 resulted 60%, 85.7%, and 100%, respectively), while earlier stages showed higher specificity (specificity for T1, T3, and T4 resulted 100%, 75%, and 91.7%, respectively). Overall N staging accuracy was 86.7%, with 13 of 15 patients correctly staged. Stage-specific sensibility was 75% for N0 and 100% for N3, while specificity was 100% for N0 and lower for advanced stages. Accuracy for peritoneal involvement was 100%. Our findings show a good performance of the diagnostic protocol performed with MDCT tested in this study.

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Bruno, L. , Barni, L. , Masini, G. , Pacciani, S. , Lucarelli, E. , Masserelli, A. , Tomcykova, D. , Melli, F. , Boni, L. , Freschi, G. and Bechi, P. (2014) Multiple Detector-Row CT in Gastric Cancer Staging: Prospective Study. Journal of Cancer Therapy, 5, 1438-1449. doi: 10.4236/jct.2014.514145.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Ferlay, J., Soerjomataram, I., Ervik, M., Dikshit, R., Eser, S., Mathers, C., Rebelo, M., Parkin, D.M., Forman, D. and Bray, F. (2012) GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11. GLOBOCAN. http://globocan.iarc.fr
[2] Decourcy Hallinan, J.T.P. and Venkatesh, S.K. (2013) Gastric Carcinoma: Imaging, Diagnosis, Staging and Assessment of Treatment Response. Cancer Imaging, 13, 212-227. http://dx.doi.org/10.1102/1470-7330.2013.0023
[3] Kwee, R.M. and Kwee, T.C. (2007) Imaging in Local Staging of Gastric Cancer: A Systematic Review. Journal of Clinical Oncology, 25, 2107-2116. http://dx.doi.org/10.1200/JCO.2006.09.5224
[4] Asano, M. (2012) Endoscopic Submucosal Dissection and Surgical Treatment for Gastrointestinal Cancer. World Journal of Gastrointestinal Endoscopy, 4, 438-447. http://dx.doi.org/10.4253/wjge.v4.i10.438
[5] Xu, A.M., Huang, L., Liu, W., Gao, S., Han, W.X. and Wei, Z.J. (2014) Neoadjuvant Chemotherapy Followed by Surgery versus Surgery Alone for Gastric Carcinoma: Systematic Review and Meta-Analysis of Randomized Controlled Trials. PLoS ONE, 9, e86941. http://dx.doi.org/10.1371/journal.pone.0086941
[6] Kim, J.W., Shin, S.S., Heo, S.H., Choi, Y.D., Lim, H.S., Park, Y.K., Park, C.H., Jeong, Y.Y. and Kang, H.K. (2012) Diagnostic Performance of 64-Secion CT Using CT Gastrography in Preoperative T Staging of Gastric Cancer According to 7th Edition of AJCC Cancer Staging Manual. European Radiology, 22, 654-662. http://dx.doi.org/10.1007/s00330-011-2283-3
[7] Washington, K. (2010) 7th Edition of the AJCC Cancer Staging Manual: Stomach. Annals of Surgical Oncology, 17, 3077-3079. http://dx.doi.org/10.1245/s10434-010-1362-z
[8] Japanese Gastric Cancer Association (1998) Japanese Classification of Gastric Carcinoma. 2nd English Edition. Gastric Cancer, 1, 10-24. http://dx.doi.org/10.1007/PL00011681
[9] Japanese Gastric Cancer Association (2011) Japanese Classification of Gastric Carcinoma. 3rd English Edition. Gastric Cancer, 14, 101-112. http://dx.doi.org/10.1007/s10120-011-0041-5
[10] Chua, Y.L. and Cunningham, D. (2007) The UK NCRI MAGIC Trial of Preoperative Chemotherapy in Resectable Gastric Cancer: Implications for Clinical Practice. Annals of Surgical Oncology, 14, 2687-2690. http://dx.doi.org/10.1245/s10434-007-9423-7
[11] Chen, C.Y., Hsu, J.S., Wu, D.C., Kang, W.Y., Hsieh, J.S., Jaw, T.S., Wu, M.T. and Liu, G.C. (2007) Gastric Cancer: Preoperative Local Staging with 3D Multi-Detector Row CT—Correlation with Surgical and Histopatologic Results. Gastrointestinal Imaging, 242, 472-482.
[12] Kwee, R.M. and Kwee, T.C. (2009) Imaging in Assessing Lymph Node Status in Gastric Cancer. Gastric Cancer, 12, 6-22. http://dx.doi.org/10.1007/s10120-008-0492-5
[13] Marrelli, D., Mazzei, M.A., Pedrazzani, C., Di Martino, M., Vindigni, C., Corso, G., Morelli, E., Volterrani, L. and Roviello, F. (2011) High Accuracy of Multislices Computed Tomography (MSCT) for Para-Aortic Lymph-Node Metastases from Gastric Cancer: A Prospective Single-Center Study. Annals of Surgical Oncology, 18, 2265-2272. http://dx.doi.org/10.1245/s10434-010-1541-y
[14] Ruschoff, J., Hanna, W., Bilous, M., Hofmann, M., Osamura, R.Y., Penault-Llorca, F., van de Vijver, M. and Viale, G. (2012) HER2 Testing in Gastric Cancer: A Practical Approach. Modern Pathology, 25, 637-650. http://dx.doi.org/10.1038/modpathol.2011.198
[15] Michel, P., Carrere, N., Lefort, C., Pezet, D., Rebischung, C., Vendrely, V. and Ychou, M. (2014) Cancer de l’estomac. Thésaurus National de Cancérologie Digestive. http://www.tncd.org/
[16] Goldtein, N.S., Soman, A. and Sacksner, J. (1999) Disparate Surgical Margin Lengths of Colorectal Resection Specimens between in Vivo and in Vitro Measurements. The Effects of Surgical Resection and Formalin Fixation on Organ Shrinkage. American Journal of Clinical Pathology, 111, 349-351.
[17] Mazzei, M.A., Khader, L., Cirigliano, A., Cioffi Squitieri, N., Guerrini, S., Forzoni, B., Marrelli, D., Roviello, F., Mazzei, F.G. and Volterrani, L. (2013) Accuracy of MDCT in the Preoperative Definition of Peritoneal Cancer Index (PCI) Patients with Advanced Ovarian Cancer Who Underwent Peritonectomy and Hypertermic Intraperitoneal Chemotherapy (HIPEC). Abdomi Imaging, 38, 1422-1430.
http://dx.doi.org/10.1007/s00261-013-0013-9

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