Staging of Advanced Gastric Cancer: Comparison of Conventional CT and Intraoperative Assessment.
10.3348/jkrs.1994.31.2.301
- Author:
Jong Sung KIM
;
On Koo CHO
;
Hyun Chul RHIM
;
Byung Hee KOH
;
Yoon Young CHOI
;
O Keun BAE
;
Chang Kok HAHM
- Publication Type:Original Article
- MeSH:
Complement System Proteins;
Endosonography;
Fibrinogen;
Humans;
Retrospective Studies;
Stomach Neoplasms*;
Tomography, Spiral Computed
- From:Journal of the Korean Radiological Society
1994;31(2):301-305
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We performed a retrospective study to compare the accuracy between conventional CT staging and intraoperative staging for advanced gastric cancer. MATERIALS AND METHODS: Sixty patients with advanced gastric cancer were included in this study during the recent 2 year-period. All were pre- and posto- peratively diagnosed as advanced gastric cancer. CTwas performed with G E 9800 and Somatom DR3 under conventional technique in 50 and with others in 10 referred patients. The CT staging for T and N category with emphasis on incurable factor, if not resacted, were performed. And we compared the accuracy between conventional CT and intraoperative staging. The final histo-pathologic staging was used as a gold standard. RESULTS: Accuracy of CT and operation for T4(n=l7) factor is 76.9 % and 86.2 % respectively. Overestimation rate for T4 was 9.3 % by CT and 6.1% by operation, and underestimation rate for was 13.8 % and 7.7 % respectively. Accuracy of CT and operation for N (n=60) factor was 50 % and 60 % respectively. Overestimation rate for N factor was 18.3 % by CT and 18.3 % by operation, and underestimation rate for N factor was 31.7 % and 21.7 % respectively. Correct Tand IM staging was possible only in 33% by CT and 38% by intraoperative assessment. CONCLUSION: Conventional CT and intraoperative staging for incurable T/N factor in advanced gastric cancer have a potential limitations, especially for N factor. Therefore, more reliable modality or technique such as dynamic scanning by spiral CT, transabdominal or endoscopic ultrasonography should be preoperatively performed to complement infrequent errors in intraoperative staging. Furthermore, a histology-oriented surgical approach seems essential in selecting the most appropriate surgical procedure.
