Gastric Cancer: Evaluation of Triphasic Spiral CT and Radiologic-Pathologic Correlation

Takao, Michiko; Fukuda, Toshio; Iwanaga, Soji; Hayashi, Kuniaki; Kusano, Hiroyuki; Okudaira, Sadayuki

doi:10.1097/00004728-199803000-00024

Cited by 92 publications

(47 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The cN-pN concordance rate in our data was 61.7 %, and it has been reported as 59-87 % in previous studies [11,[31][32][33][34]. These results imply a limitation to the diagnosis of LN metastasis.…”

Section: Discussionsupporting

confidence: 62%

“…In studies based on MDCT, the concordance between cT and pT was reported to be 76-89 % [11,[31][32][33][34]; however, the number of participants in these studies was small, ranging from 50 to 108, making the conclusions unreliable. Furthermore, the reports differed in the classification methods and the number of categories for cancer depth, making a generalized comparison impossible.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

et al. 2016

View full text Add to dashboard Cite

Background Preoperative clinical staging of gastric cancer is used to determine therapeutic strategies. However, the impact of the clinical stage on survival has not been completely investigated, although the relationship between pathologic staging and survival outcome has been reported. The aim of the present study was to clarify the predictability of patient survival based on clinical staging and to evaluate the usefulness of staging as an indicator for selecting the treatment modality. Methods A total of 3033 patients who underwent surgery for gastric cancer were included. A survival analysis was conducted based on the seventh edition of the tumor-nodemetastasis (TNM) clinical staging system of the American Joint Committee on Cancer. The predictive ability of the TNM clinical stage for survival was evaluated by Harrell's C-index, a measure of the separation of survival distributions.Results The cumulative 5-year survival rates according to the clinical stage were 94.3 % (IA), 84.7 % (IB), 71.7 % (IIA), 56.1 % (IIB), 55.7 % (IIIA), 42.3 % (IIIB), 22.8 % (IIIC), and 9.1 % (IV). Although no significant difference was observed between clinical stages IIB and IIIA (p = 0.865), significant differences existed between all other clinical stages (p \ 0.001). Harrell's C-index applied to these results was 0.825 (95 % confidence interval 0.819-0.831). Conclusions The seventh edition of the TNM clinical staging system has a strong prognostic ability with a satisfactory C-index and should be considered valuable for selecting therapeutic strategies for the treatment of gastric cancer.

show abstract

Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 97%

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

et al. 2016

View full text Add to dashboard Cite

show abstract

“…The third limitation of this study was that we did not obtain the gastric mucosal phase. The layered pattern of the normal gastric wall and early gastric cancer can be depicted clearly in the gastric mucosal phase [24,25]. It is useful for identifying the enhancement pattern of early gastric cancer [24] and for determining the depth of tumour invasion [25].…”

Section: H J Kim D H Lee and Y T Komentioning

confidence: 99%

“…The layered pattern of the normal gastric wall and early gastric cancer can be depicted clearly in the gastric mucosal phase [24,25]. It is useful for identifying the enhancement pattern of early gastric cancer [24] and for determining the depth of tumour invasion [25]. It also may be useful for tumour detection, especially for those tumours without obvious gastric wall thickening [8].…”

Section: H J Kim D H Lee and Y T Komentioning

confidence: 99%

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Kim

Lee²,

Ko³

2010

BJR

View full text Add to dashboard Cite

ABSTRACT. The aim of this study is to compare blinded with partially blinded detection of gastric cancer with multidetector (MD) CT by using surgery and endoscopic submucosal dissection (ESD) as reference standards. 44 patients with gastric cancer underwent MDCT with air as an oral contrast agent. Surgery was performed on 37 patients, ESD on six and surgery after ESD on one. To provide comparison cases of blinded evaluation, 38 MDCT examinations were added for cases where no focal gastric lesion was seen on endoscopy. Two radiologists, blinded to the presence, number and location of the tumours, evaluated axial and axial plus multiplanar reformation (MPR) images of 82 MDCT examinations with or without gastric cancer. For partially blinded evaluation, the same radiologists, blinded to the location and number of tumours, evaluated axial and axial plus MPR images of 44 MDCT examinations of gastric cancer. Differences in assessment were resolved by consensus. 45 gastric cancers were found in surgical and ESD specimens. Detection rates of gastric cancer from axial and axial plus MPR images during blinded evaluation and from axial and axial plus MPR images during partially blinded evaluation were 62% (28/45), 64% (29/45), 64% (29/45) and 71% (32/45), respectively. There was no statistical significance for the comparison between blinded and partially blinded detection rates of gastric cancer. The detection rate of gastric cancer with MDCT during blinded evaluation showed no specific difference compared with the detection rate of gastric cancer with MDCT during partially blinded evaluation. . However, patients with early gastric cancer have 5-year survival rates of more than 85% [3,4]. Therefore, early detection of gastric cancer is essential for the improvement of patient survival and for the reduction of the overall use of medical resources. Although the use of endoscopy and a double-contrast barium study has a significant role in the detection of gastric cancer, the depth of tumour invasion and the presence or absence of metastasis cannot be determined by the use of these modalities. Multidetector CT (MDCT) is usually performed for pre-operative staging work-up of patients with gastric cancer. Accurate evaluation of the location and local extent of the gastric cancer (T stage) is important in the choice of the optimal therapeutic approach. However, if gastric cancer cannot be detected on MDCT, the modality cannot provide the information about the location and T stage of gastric cancer. Thus, lesion detection on MDCT is a prerequisite for gastric cancer staging on MDCT [5].Currently, some early gastric cancers may be treated with laparoscopic gastrectomy or endoscopic submucosal dissection (ESD) without laparotomy [6,7]. However, most studies on gastric cancer have confined the study population to patients who have received a laparotomy [5,[8][9][10][11]. This strict confinement of the study population may result in an overestimation of the detection rate of gastric cancer. Most results for the detection rate of gastr...

show abstract

“…However, the accuracy of establishing the N category is still poor ; 63 -78 using EUS [5][6][7][8][9][10][11] and 51 -78 using CT 9,[12][13][14][15][16][17][18] . The N category estimates 5-year survival rate in patients with N0 gastric cancer as 89.4 , but 68.3 in those with N1 disease 19 .…”

mentioning

confidence: 99%

Expression of Standard CD44 in Advanced Gastric Cancer: Relationship with Metastasis to Lymph Nodes

Arima

Kunimura

Date

et al. 2010

Showa Univ J Med Sci

View full text Add to dashboard Cite

IntroductionGastric cancer is the second most common cause of cancer related mortality worldwide 1 . Complete surgical resection, the only potentially curative treatment for advanced gastric cancer, can only be performed on a small subgroup of patients. In 30 to 50 of patients undergoing surgical exploration, the intent of the surgery is to cure the patient. However, almost 60 of patients who undergo an R0 curative resection relapse and die of their disease 2, 3 .Clinical staging is determined using TNM classi cation : T indicating depth of invasion of the primary tumor, N nodal metastasis, and M distant metastasis. This classi cation system is useful to estimate patient prognosis. Currently, endoscopic ultrasound EUS and computed tomography CT are widely used for preoperative tumor staging 4 . The accuracy of 58 / 98 of tumors. CD44s expression showed no signi cant relationship with patient age or gender, or tumor location, size or macroscopic / microscopic classi cation. However, CD44s expression showed a signi cantly negative relationship with metastasis to lymph nodes p 0.0001 . Thus, in T2-T3 gastric cancer, loss of CD44s expression suggests that metastasis of the tumor to lymph nodes is likely.

show abstract

Gastric Cancer: Evaluation of Triphasic Spiral CT and Radiologic-Pathologic Correlation

Abstract: Spiral CT with triphasic scan technique improved the accuracy of estimating the depth of tumor invasion in advanced gastric cancer.

Cited by 92 publications

References 16 publications

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

Impact of clinical tumor–node–metastasis staging on survival in gastric carcinoma patients receiving surgery

Comparison between blinded and partially blinded detection of gastric cancer with multidetector CT using surgery and endoscopic submucosal dissection as reference standards

Expression of Standard CD44 in Advanced Gastric Cancer: Relationship with Metastasis to Lymph Nodes

Contact Info

Product

Resources

About