medigraphic.com

2014, Number 3

<< Back Next >>

Anales de Radiología México 2014; 13 (3)

Usefulness of multidetector computed tomography in staging of gastric cancer

Jaime-Suárez BM, García-Ríos LE, Martínez-Sánchez YL, Sánchez-Luna C, Sotelo-Martínez L, Medrano-Guzmán R

Language: Spanish
References: 20
Page: 202-217
PDF size: 925.94 Kb.


ABSTRACT

Gastric cancer is one of the leading causes of morbidity and mortality in Mexico. Complete surgical resection continues to be the primary treatment option in patients without evidence of metastasis and should be the initial therapy for technically extirpable tumors. Precision in preoperative staging is essential to select patients who may benefit from the surgery. Multidetector computed tomography performed correctly and focused on defining specific parameters by means of multiplanar reconstructions is possible.
Objective: evaluate the usefulness of multidetector computed tomography in local, nodal, and distant staging of gastric cancer.
Material and methods: retrospective, transverse analysis in which patients with diagnosis of gastric adenocarcinoma (who had multidetector computed tomography) were chosen from January 2012 through March 2014. For patients admitted for surgery the report on stage TNM (T: wall infiltration; N: nodal metastasis; M: distant metastasis) was compared by multidetector computed tomography, surgery, and the final pathology opinion. A bivariate analysis of the cases studied was conducted.
Result: 77 patients were included, in whom 64.94% of tumors were considered unresectable; multidetector computed tomography showed invasion of adjacent organs, primary blood vessels, tumoral spread to the esophagogastric junction, carcinomatosis, and hepatic metastasis. Thirty-two patients underwent surgery and only in 27 were tumors successfully resected, the most consistent TNMs between multidetector computed tomography and surgery were T4 (invasion of serous layer) and N2 (invasion in 2 to 6 regional lymph nodes).
Conclusion: multidetector computed tomography showed greater consistency in detecting T4 and N2 invasions in gastric cancer.


REFERENCES

  1. GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide. Disponible en: http://globocan.iarc.fr

  2. Antonio de la Torre Bravo, Walter Kettenhofen, Enríquez, et al. Guía de Diagnóstico y Tratamiento del Cáncer Gástrico. Epidemiología, Factores de riesgo, Variedades histológicas e Historia natural. Revista de Gastroenterología de México 2010;2(75):237-239.

  3. Luis F. Oñate-Ocaña. Gastric Cancer in Mexico. Gastric cáncer 2001;4:162-164.

  4. Catherine de Martel, David Forman, BA, Martyn Plummer. Gastric Cancer. Epidemiology and Risk Factors. Gastroenterol Clin N Am 2013;42:219-240.

  5. Pelayo Correa MD. Gastric Cancer: Overview. Gastroenterol Clin N Am 2013;42:211-217.

  6. Martin RC 2nd, Jaques DP, Brennan MF, Karpeh M. Extended local resection for Advanced Gastric Cancer: Increased Survival Versus Increased Morbidity. Ann Surg 2002;236(2):159–165.

  7. Nitti D, Marchet A, Mammano E, et al. Extended Lymphadenectomy (D2) in patients with Early Gastric Cancer. Eur J SurgOncol 2005;31(8):875–881.

  8. Blakely AM, Miner TJ. Surgical Considerations in the Treatment of Gastric Cancer. Gastroenterol Clin N Am 2013;42:337-357.

  9. Wadwa R, Taketa T, Sudo K. Modern Oncological Approaches to Gastric Adenocarcinoma. Gastroenterol Clin N Am 2013;42:359-369.

  10. Yulan Shen, Heoung Keun Kang, Yong Yeon Jeong. Evaluation of Early Gatric Cancer at Multidetector CT with Multiplanar Reformation and Virtual Endoscopy. Radiographics 2011;31:189–199.

  11. Lee J, Lee JM, Kim SH. Diagnostic performance of 64 – channel Multidetector CT in the evaluation of Gastric Cancer: Differentiation of Mucosal Cancer (T1a) from Submucosal Involvement (T1b and T2). Radiology 2010;255(3):805-814.

  12. Chen CY, Hsu JS, Wu DC, et al. Gastric cancer: preoperative local staging with 3D multi–detector row CT—correlation with Surgical and Histopathologic Results. Radiology 2007;242(2):472–482.

  13. Ahmed Ba-Ssalamah, Mathias Prokop, Martin Uffmann. Dedicated Multidetector CT of the Stomach: Spectrum of Diseases. Radiographics 2003;23:625–644.

  14. Karen M. Horton, Elliot K. Fishman. Current Role of CT in Imaging of the Stomach. Radiographics 2003;23:75–87.

  15. Mani NB, Suri S, Gupta S, Wig JD. Two-phase Dynamic Contrast-Enhanced Computed Tomography with waterfilling method for Staging of Gastric Carcinoma. Clin Imaging 2001;25(1):38–43.

  16. A. Martínez Martínez, A. Medina Benítez. García Roa V. Ruiz Perona Á. Salmerón Ruiz A. A. Molina Martín; Granada/ES. Validez diagnóstica de la TCMD en la estadificación T y N del cáncer gástrico. SERAM 2012.

  17. American Joint Committee on Cancer: AJCC Cancer Staging Manual, 7thed. New York: Springer 2010; pp. 117-26.

  18. Shaaban-Blodget, et al. Stomach Carcinoma. Diagnostic Imaging Oncology. Amirsys/Marban 2012;4-28, 4-51.

  19. Nishi M, Omori Y, Miwa K. Japanese Research Society for Gastric Cancer (JRSGC): Japanese classification of gastric carcinoma. 1st. English ed. Tokyo, Japan: Kanehara, 1995;6–15.

  20. National Comprehensive Cancer Network (NCCN) Version 2.2013, Gastric Cancer. NCCN.Org




2020     |     www.medigraphic.com