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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Article info
Publication history
Published online: February 11, 2011
Accepted:
December 7,
2010
Identification
Copyright
© 2011 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
