CT volumetry for gastric carcinoma: association with TNM stage

Hallinan, James Thomas Patrick Decourcy; Venkatesh, Sudhakar K.; Peter, Luke; Makmur, Andrew; Yong, Wei Peng; So, Jimmy Bok Yan

doi:10.1007/s00330-014-3316-5

Cited by 27 publications

(36 citation statements)

References 32 publications

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“…CT volumetric parameter has gained acceptance as a prognostic marker for gastric cancer [9] since Kikuchi et al reported the usefulness of CT volumetry to predict patients’ survival as well as predict TNM staging in gastric cancer [10, 11]. In terms of rectal cancer, there have been several reports showing the usefulness of CT or MR volumetry to predict treatment response after chemoradiation therapy [12–15].…”

Section: Introductionmentioning

confidence: 99%

CT volumetric measurement of colorectal cancer helps predict tumor staging and prognosis

et al. 2017

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PurposeTo evaluate feasibility of CT colonography (CTC) volumetry of colorectal cancer (CRC) and its correlation with disease stage and patients’ survival.Materials and methodsCTC volumetry was performed for 126 patients who underwent preoperative CTC. Reproducibility of tumor volume (Tvol) between two readers was assessed. One-way ANOVA and ROC analysis evaluated correlation between Tvol and pTNM staging. ROC analysis compared diagnostic performance to predict pTNM staging between Tvol and radiologist. Kaplan-Meier test compared overall survival.ResultsReproducibility among readers was excellent (interclass correlation = 0.9829). Mean Tvol showed an incremental trend with T stage and Tvol of pT4b stage was significantly larger than other stages (P<0.0001). Az value (0.780) of Tvol to predict pT4b stage was significantly larger than that (0.591) of radiologist (P = 0.004). However, Tvol was not significantly different according to pN stage. Az values (0.723~0.857) of Tvol to predict M1 or M1b were comparable to those (0.772~0.690) of radiologist (P>0.05). Smaller tumor burden (≤12.85cm3), ≤T3, N0, M0 stages, and curative surgery were significantly associated with patients’ longer survival (P<0.05).ConclusionCT volumetry has a limited value to predict N stage; however, it may outperform the radiologist’s performance when predicting pT4b and M1b stage and can be a useful prognostic marker.

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Section: Introductionmentioning

confidence: 99%

CT volumetric measurement of colorectal cancer helps predict tumor staging and prognosis

et al. 2017

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“…In other words, the serosal defects of color-diffused type GC reflect an invasive tendency of primary tumor that is undetectable in the course of preoperative imaging and other diagnostics. [20][21][22] This explains the observed homogeneity of prognosis across all stages of color-diffused type GC, as detailed herein. Furthermore, such defects may create difficulty in determining an accurate histologic depth of invasion.…”

Section: Discussionmentioning

confidence: 73%

Macroscopic Serosal Classification as a Prognostic Index in Radically Resected Stage pT3–pT4b Gastric Cancer

et al. 2015

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“…Kikuchi et al (18) suggested that staging system based on tumor volume measured from continuous tissue sections by the surface rendering method after surgery may have advantages over conventional staging systems for gastric cancer. Previously published data showed that tumor volume measured by CT is also feasible and reproducible, which could provide useful adjunct information for TNM staging of gastric cancer (13). They demonstrated that CT volumetry correlated well with T and N stages for gastric cancer without preoperative treatment with an AUC of 0.89 for ≥T2 stage and 0.75 for ≥N1 stage.…”

Section: Discussionmentioning

confidence: 98%

“…They suggested that T-staging by CT after neoadjuvant chemotherapy should not be considered in clinical decision-making. More recently, studies reported that tumor volume measurement could provide useful information for preoperative staging (13), assessment of response to neoadjuvant chemotherapy (14), and predicting prognosis of gastric cancer (15). Tumor volume reduction rates were significantly correlated with histopathologic grades of tumor regression in gastric cancer patients with a tumor volume reduction rate of 35.6% or higher (14).…”

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CT volumetry can potentially predict the local stage for gastric cancer after chemotherapy

Wang

Wang²,

Ding³

et al. 2017

Diagn Interv Radiol

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G astric cancer is the fifth most common malignancy in the world, and about half of the cases in the world occur in Eastern Asia, mainly in China (1-3). Complete tumor excision of the tumor is the first-line therapy for gastric cancer (4). However, even after potentially curative resection with satisfactory safety margins, the prognosis of patients with locally advanced gastric cancer is still worrying. Consequently, adjuvant and neoadjuvant therapies are now increasingly used in conjunction with surgery for locally advanced gastric cancer, which can significantly downstage the tumor, improve R0 resection rate, progression-free survival, and overall survival (5, 6).The accurate evaluation of preoperative TNM staging of gastric cancer is essential for selecting the optimal treatment method and predicting prognosis (7). Lu et al. (8) reported that depth of invasion, lymph node metastasis stage, metastatic lymph node ratio, lymphatic invasion, and tumor size were independent predictors of prognosis in gastric cancer patients who underwent radical surgery (R0 resection). Shiraishi et al. (9) demonstrated that serosal invasion, extragastric lymph node metastasis, and liver metastasis were independent prognostic factors in patients with large gastric cancer. Endoscopic ultrasonography (EUS) and CT are currently the main methods of staging gastric cancer. EUS has been in use since the 1980s and is reported to have high T staging accuracy. CT has a great advantage on the evaluation of T stage and is considered the best modality for the staging of gastric cancer, as it can perform 257 From the Department of Radiology (S-X.R.  raoxray@163.com), Zhongshan Hospital, Fudan University, Shanghai, China. METHODSThis study retrospectively evaluated 42 patients diagnosed with gastric cancer, who underwent chemotherapy followed by surgery. Pre-and post-treatment CT tumor volumes (V T ) were measured in portal venous phase and volume reduction ratios were calculated. Correlations between pre-and post-treatment V T , reduction ratio, and pathologic stages were analyzed. Receiver operator characteristic (ROC) analyses were also performed to assess diagnostic performance for prediction of downstaging to T0-2 stage and N0 stage. RESULTSPretreatment V T , post-treatment V T , and V T reduction ratio were significantly correlated with T stage (r s =0.329, r s =0.546, r s = -0.422, respectively). Post-treatment V T and V T reduction ratio were significantly correlated with N stage (r s =0.442 and r s = -0.376, respectively). Pretreatment V T , post-treatment V T , and V T reduction ratio were significantly different between T0-2 and T3,4 stage tumors (P = 0.05, P < 0.001, and P = 0.002, respectively). The differences between N0 and ≥N1 groups were also statistically significant (P = 0.005 for post-treatment V T , P = 0.016 for V T reduction ratio, respectively). The area under the ROC curve (AUC) for identification of T0-2 groups was 0.70 for pretreatment V T , 0.88 for post-treatment V T , and 0.82 for V T reduction ratio, respective...

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CT volumetry for gastric carcinoma: association with TNM stage

Cited by 27 publications

References 32 publications

CT volumetric measurement of colorectal cancer helps predict tumor staging and prognosis

CT volumetric measurement of colorectal cancer helps predict tumor staging and prognosis

Macroscopic Serosal Classification as a Prognostic Index in Radically Resected Stage pT3–pT4b Gastric Cancer

CT volumetry can potentially predict the local stage for gastric cancer after chemotherapy

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