Diagnostic Accuracy of Computed Tomography for the Lymph Node Staging of Endoscopically Resectable Early Gastric Cancer.
- Author:
Tae Hoon OH
1
;
Ban Suck LEE
;
Min Geun KIM
;
Jeong Soo AHN
;
Tae Joo JEON
;
Dong Dae SEO
;
Won Choong CHOI
;
Won Chang SHIN
;
Myeong Ja JEONG
;
Hyun Jung KIM
Author Information
1. Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. osbbang@hanmail.net
- Publication Type:Original Article
- Keywords:
Early gastric cancer;
Computed tomography;
Endoscopic mucosal resection;
Neoplasm staging
- MeSH:
Asian Continental Ancestry Group;
Humans;
Lymph Nodes;
Medical Records;
Neoplasm Metastasis;
Neoplasm Staging;
Stomach Neoplasms
- From:Korean Journal of Gastrointestinal Endoscopy
2008;37(2):90-96
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Accurate staging of the lymph nodes (LNs) before endoscopic mucosal resection (EMR) is important. We evaluated the accuracy of CT for LN staging in patients the endoscopically resectable early gastric cancer (EGC). METHODS: The medical records of 155 EGCs patients who had undergone an operation were analyzed. The pre-operatively performed multidetector CT scans and the post-operative histopathologic findings were reviewed for comparing the LN staging with that using the Japanese classification system. Endoscopically resectable EGC was defined as EGC without LN metastasis and also the EGC that satisfied the EMR criteria according to the Japanese guideline. RESULTS: The diagnostic efficacy of CT for LN staging of all the enrolled EGC patients was as follow: accuracy 65.2%, overstaging rate 29.7%, understaging rate 5.2%. The overall accuracy and the overstaging rate of CT for LN staging of endoscopically resectable EGC were as follows: EGC without LN metastasis [69.8% (97/139), 30.2% (42/139)], EGC satisfying extended criteria [72.5% (58/80), 27.5% (22/80)] and EGC satisfying limited criteria [79.2% (19/24), 20.8% (5/24)]. The accuracy of the EMR criteria for predicting node negative EGC were as follows: the extended criteria 98.8% (79/80), the limited criteria 100% (24/24). CONCLUSIONS: Our study showed that prediction of LN metastasis before EMR according to CT staging had limited value due to the tendency of overestimation. Therefore, we should preferentially consider the treatment strategy according to the EMR criteria.
