Quality of abdominal contrast tomography for gastric cancer staging in patients candidates for surgical management in a high-complexity institution in the city of Medellín, Colombia
DOI:
https://doi.org/10.35509/01239015.997Keywords:
Tomography, x-ray computed, stomach neoplasms, neoplasm stagingAbstract
Objectives: Gastric cancer is currently the fifth cancer in prevalence and the third cause of cancer mortality globally. Gastric cancer staging has become the axis of decision-making for the proper management of this type of cancer. This research seeks to evaluate the quality of contrast computed tomography (CT) of the abdomen for gastric cancer staging, whether early or advanced, in a high-complexity hospital in Medellín, Colombia.
Methods: A total of 160 patients diagnosed with gastric cancer confirmed by histology were retrospectively evaluated in a tertiary institution in the city of Medellín, Colombia, between January 2015 and September 2022. In 50 patients who met the inclusion and exclusion criteria, the results of the preoperative abdominal contrast CT and the findings of pathological anatomy in the surgical gastrectomy specimen were evaluated and correlated.
Results: Accuracy for tumor stage (T) was 30% (15/50), and accuracy for nodal stage (N) was 32% (16/50). The diagnostic accuracy of abdominal contrast CT for early gastric carcinoma was 75%, with high specificity (91%) but moderate sensitivity (83%).
Conclusion: Abdominal contrast CT in our population had a limited role in gastric cancer staging, both for tumor stage (T) and lymph node stage (N).
Author Biographies
Julián Esteban Henao-Ardila, Especialista en entrenamiento, Programa de Cirugía Oncológica, Universidad de Antioquia, Medellín, Colombia.
1. Especialista en entrenamiento, Programa de Cirugía Oncológica, Universidad de Antioquia, Medellín, Colombia.
Juan Camilo Correa-Cote, Clínica Medellín, Grupo Quironsalud, Medellín, Colombia.
2. Clínica Medellín, Grupo Quironsalud, Medellín, Colombia.
3. Departamento de Cirugía, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia.
Claudia Patricia Huertas-Duran, Imágenes diagnósticas SURA, Grupo SURA, Medellín, Colombia.
4. Imágenes diagnósticas SURA, Grupo SURA, Medellín, Colombia.
5. Departamento de Radiología, Instituto Neurológico de Colombia, Medellín, Colombia.
6. Departamento de Radiología, Clínica Las Américas (Grupo AUNA), Medellín, Colombia.
References
Haseeb Wani A, Hussain Parry A, Feroz I, Ahmad Choh N. Preoperative staging of gastric cancer using computed tomography and its correlation with histopathology with emphasis on multi-planar reformations and virtual gastroscopy. J Gastrointest Canc [Internet]. 2021 [citado: 2022 feb 18];52:606-15. https://doi.org/10.1007/s12029-020-00436-6
International Agency for Research on Cancer. Estimated age-standardized incidence rates (World) in 2020, all cancers, both sexes, all ages [Internet]. 2020 [citado: 2023 jun 10]. Disponible en: https://gco.iarc.fr/today/online-analysis-map?v=2020&mode=population&mode_population=continents&population=900&populations=900&key=asr&sex=0&cancer=39&type=0&statistic=5&prevalence=0&population_group=0&ages_group%5B%5D=0&ages_group%5B%5D=17&nb_items=10&group_cancer=1&include_nmsc=0&include_nmsc_other=0&projection=natural-earth&color_palette=default&map_scale=quantile&map_nb_colors=5&continent=0&show_ranking=0&rotate=%255B10%252C0%255D
Kawanaka Y, Kitajima K, Fukushima K, Mouri M, Doi H, Oshima T, et al. Added value of pretreatment 18F-FDG PET/CT for staging of advanced gastric cancer: Comparison with contrast-enhanced MDCT. Eur J Radiol. 2016;85(5):989-95. https://doi.org/10.1016/j.ejrad.2016.03.003
Berlth F, Chon SH, Chevallay M, Jung MK, Mönig SP. Preoperative staging of nodal status in gastric cancer. Transl Gastroenterol Hepatol. 2017;2:8. https://doi.org/10.21037/tgh.2017.01.08
Zhang XF. Surgical treatment and prognosis of gastric cancer in 2 613 patients. World J Gastroenterol. 2004;10(23):3405-08. https://doi.org/10.3748/wjg.v10.i23.3405
Jin Kim S, Kim HH, Hoon Kim Y, Hwi Hwang S, Seung Lee H, Joong Park D, et al. Peritoneal metastasis: detection with 16-or 64-detector row CT in patients undergoing surgery for gastric cancer 1 from the departments of radiology. Radiology. 2009;253(2):407-15. https://doi.org/10.1148/radiol.2532082272
Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. The Lancet. 2020;396(10251):635-48. https://doi.org/10.1016/s0140-6736(20)31288-5
Lordick F, Carneiro F, Cascinu S, Fleitas T, Haustermans K, Piessen G, et al. Gastric cancer: ESMO clinical practice guideline for diagnosis, treatment and follow-up. Ann Oncol. 2022;33(10):1005-20. https://doi.org/10.1016/j.annonc.2022.07.004
Ajani JA, D’Amico TA, Bentrem DJ, Chao J, Cooke D, Corvera C, et al. Gastric cancer, version 2.2022, NCCN clinical practice guidelines in oncology. J National Comprehensive Cancer Network. 2022;20(2):167-92. https://doi.org/10.6004/jnccn.2022.0008
Giandola T, Maino C, Marrapodi G, Ratti M, Ragusi M, Bigiogera V, et al. Imaging in gastric cancer: current practice and future perspectives. Diagnostics. 2023;13(7):1276. https://doi.org/10.3390/diagnostics13071276
Espinosa JL, Suárez LM, Guevara RE, Mendivelso FO. Utilidad de la laparoscopia de estadificación frente a la tomografía axial computarizada para detectar metástasis peritoneales en el adenocarcinoma gástrico avanzado. Rev Colomb Cir. 2019;34(3):254-9. https://doi.org/10.30944/20117582.439
Sugarbaker PH. Laparoscopy in the diagnosis and treatment of peritoneal metastases. Ann Laparosc Endosc Surg. 2019;4:42. https://doi.org/10.21037/ales.2019.04.04
D’Ugo DM, Pende V, Persiani R, Rausei S, Picciocchi A. Laparoscopic staging of gastric cancer: an overview. J Am Coll Surg. 2003;196(6):965-74. https://doi.org/10.1016/S1072-7515(03)00126-1
Gertsen EC, Brenkman HJF, van Hillegersberg R, van Sandick JW, van Berge Henegouwen MI, Gisbertz SS, et al. 18 F-Fludeoxyglucose-positron emission tomography/computed tomography and laparoscopy for staging of locally advanced gastric cancer. JAMA Surg. 2021;156(12):e215340. https://doi.org/10.1001/jamasurg.2021.5340
Kim SH, Choi YH, Kim JW, Oh S, Lee S, Kim BG, et al. Clinical significance of computed tomography-detected ascites in gastric cancer patients with peritoneal metastases. Medicine. 2018;97(8):e9343. https://doi.org/10.1097/MD.0000000000009343
Kim SJ, Kim HH, Kim YH, Hwang SH, Lee HS, Park DJ, et al. Peritoneal metastasis: detection with 16– or 64–detector row CT in patients undergoing surgery for gastric cancer. Radiology. 2009;253(2):407-15. https://doi.org/10.1148/radiol.2532082272
Jiang M, Wang X, Shan X, Pan D, Jia Y, Ni E, et al. Value of multi-slice spiral computed tomography in the diagnosis of metastatic lymph nodes and N-stage of gastric cancer. J Int Med Res. 2019;47(1):281-92. https://doi.org/10.1177/0300060518800611
Kim JH, Eun HW, Hong SS, Kim YJ, Han JK, Choi BI. Gastric cancer detection using MDCT compared with 2D axial CT: diagnostic accuracy of three different reconstruction techniques. Abdom Imaging. 2012;37(4):541-8. https://doi.org/10.1007/s00261-011-9823-9
Pan Z, Zhang H, Yan C, Du L, Ding B, Song Q, et al. Determining gastric cancer resectability by dynamic MDCT. Eur Radiol. 2010;20(3):613-20. https://doi.org/10.1007/s00330-009-1576-2
Chen CY, Hsu JS, Wu DC, Kang WY, Hsieh JS, Jaw TS, et al. Gastric cancer: preoperative local staging with 3D multi–detector row CT—correlation with surgical and histopathologic results. Radiology. 2007;242(2):472-82. https://doi.org/10.1148/radiol.2422051557
Kim HJ, Kim AY, Oh ST, Kim JS, Kim KW, Kim PN, et al. Gastric sancer staging at multi–detector row CT gastrography: comparison of transverse and volumetric CT scanning. Radiology. 2005;236(3):879-85. https://doi.org/10.1148/radiol.2363041101
Ba-Ssalamah A, Prokop M, Uffmann M, Pokieser P, Teleky B, Lechner G. Dedicated multidetector CT of the stomach: Spectrum of diseases. Radiographics [Internet]. 2003;23(3):625-44. https://doi.org/10.1148/rg.233025127
Lawrence J, Burgart M, William V, Chopp M, Dhanpat Jain M. Protocol for the examination of specimens from patients with carcinoma of the stomach [Internet]. 2022. [citado: 2023 abr 5]. Disponible en: https://documents.cap.org/documents/Stomach_4.4.0.0.REL_CAPCP.pdf
Su PF, Yu JC. Progress in neoadjuvant therapy for gastric cancer (Review). Oncol Lett. 2022;23(6):172. https://doi.org/10.3892/ol.2022.13292.
Habermann CR, Weiss F, Riecken R, Honarpisheh H, Bohnacker S, Staedtler C, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US. Radiology. 2004;230(2):465-71. https://doi.org/10.1148/radiol.2302020828
Cardona A, Márquez A, Osorio G. Correlación entre los hallazgos imagenológicos y los resultados histopatológicos en carcinoma gástrico [Internet]. Universidad de Antioquia; 2022 [citado: 2023 abr 5]. Disponible en: https://bibliotecadigital.udea.edu.co/bitstream/10495/29472/1/CardonaAlejandro_2022_%20CancerGastricoTomografia.pdf
Kim TU, Kim S, Lee JW, Lee NK, Jeon TY, Park DY. MDCT features in the differentiation of T4a gastric cancer from less-advanced gastric cancer: significance of the hyperattenuating serosa sign. Br J Radiol. 2013;86(1029):20130290. https://doi.org/10.1259/bjr.20130290
Kim JW, Shin SS, Heo SH, Choi YD, Lim HS, Park YK, et al. Diagnostic performance of 64-section CT using CT gastrography in preoperative T staging of gastric cancer according to 7th edition of AJCC cancer staging manual. Eur Radiol. 2012;22(3):654-62. https://doi.org/10.1007/s00330-011-2283-3
Bruno L, Barni L, Masini G, Pacciani S, Lucarelli E, Masserelli A, et al. Multiple detector-row CT in gastric cancer staging: prospective study. J Cancer Ther. 2014;05(14):1438-49. https://doi.org/10.4236/jct.2014.514145
Vergadis C, Schizas D. Is accurate N – staging for gastric cancer possible? Front Surg. 2018;5:41. https://doi.org/10.3389/fsurg.2018.00041
Moschetta M, Scardapane A, Telegrafo M, Lorusso V, Angelelli G, Ianora AAS. Differential diagnosis between benign and malignant ulcers: 320-row CT virtual gastroscopy. Abdom Imaging. 2012;37(6):1066-73. https://doi.org/10.1007/s00261-012-9849-7
Kumagai K, Sano T. Revised points and disputed matters in the eighth edition of the TNM staging system for gastric cancer. Jpn J Clin Oncol. 2021;51(7):1024-7. https://doi.org/10.1093/jjco/hyab069
Al-Batran SE, Homann N, Pauligk C, Goetze TO, Meiler J, Kasper S, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. The Lancet. 2019;393(10184):1948-57. https://doi.org/10.1016/S0140-6736(18)32557-1
Sandø AD, Fougner R, Røyset ES, Dai HY, Grønbech JE, Bringeland EA. Response evaluation after neoadjuvant chemotherapy for resectable gastric cancer. Cancers. 2023;15(8):2318. http://dx.doi.org/10.3390/cancers15082318
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