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Nodal Counts on MDCT as a Surrogate Marker for Surgical Curability in Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Thin-slice multidetector row computed tomography (MDCT) has emerged as a promising diagnostic modality in various cancers. This study was designed to evaluate the utility of metastatic nodal counts on MDCT as a surrogate maker for surgical curability in gastric cancer.

Methods

Between 2005 and 2007, a total of 92 patients with gastric cancer underwent preoperative MDCT at a slice thickness of 1.0 mm at our hospital. All regional lymph nodes showing metastatic involvement were preoperatively counted.

Results

Although the total counts of metastatic lymph nodes on MDCT were significantly smaller than those found by histopathology (P = 0.00001), there was a significant correlation between nodal counts on MDCT and histopathology by Spearman’s analysis [P < 0.0001, pathologic counts = 1.63x (counts on MDCT) + 2.5]. Nodal counts on MDCT of ≥4 were analyzed as putative pathologic nodal counts of ≥8 by the equation, and pathologic metastatic nodal counts of ≥8 were most significantly correlated with noncurative resection (P < 0.0001). According to the logistic regression analysis, nodal counts on MDCT of ≥4 were a significant independent variable for noncurative resection (P = 0.0052, odds ratio 26.68). Nodal counts on MDCT of ≥4 could distinguish noncurative patients from curative patients with 94.4% sensitivity and 71.6% specificity.

Conclusions

Nodal counts on MDCT could be a reliable surrogate maker for surgical curability of gastric cancer. This marker might enable us to select prospective candidates for additional or alternative treatments in gastric cancer.

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Tsutomu Kawaguchi MD, Shuhei Komatsu MD, Daisuke Ichikawa MD, Kazuma Okamoto MD, Atsushi Shiozaki MD, Hitoshi Fujiwara MD, Yasutoshi Murayama MD, Yoshiaki Kuriu MD, Hisashi Ikoma MD, Masayoshi Nakanishi MD, Toshiya Ochiai MD, Yukihito Kokuba MD & Eigo Otsuji MD

  2. Division of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Tsunehiko Nishimura MD

Authors
  1. Tsutomu Kawaguchi MD
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  2. Shuhei Komatsu MD
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  3. Daisuke Ichikawa MD
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  4. Kazuma Okamoto MD
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  5. Atsushi Shiozaki MD
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  6. Hitoshi Fujiwara MD
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  7. Yasutoshi Murayama MD
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  8. Yoshiaki Kuriu MD
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  9. Hisashi Ikoma MD
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  10. Masayoshi Nakanishi MD
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  11. Toshiya Ochiai MD
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  12. Yukihito Kokuba MD
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  13. Tsunehiko Nishimura MD
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  14. Eigo Otsuji MD
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Corresponding author

Correspondence to Daisuke Ichikawa MD.

Additional information

Kawaguchi and Komatsu have contributed equally to this work.

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Kawaguchi, T., Komatsu, S., Ichikawa, D. et al. Nodal Counts on MDCT as a Surrogate Marker for Surgical Curability in Gastric Cancer. Ann Surg Oncol 19, 2465–2470 (2012). https://doi.org/10.1245/s10434-012-2283-9

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  • DOI: https://doi.org/10.1245/s10434-012-2283-9

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