J Korean Radiol Soc.  1994 Aug;31(2):301-305.

Staging of Advanced Gastric Cancer: Comparison of Conventional CT and Intraoperative Assessment

• Kim JS
• Cho OK
• Rhim HC
• Koh BH
• Choi YY
• Bae OK
• Hahm CK

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.

MeSH Terms

Complement System Proteins
Endosonography
Fibrinogen
Humans
Retrospective Studies
Stomach Neoplasms*
Tomography, Spiral Computed
Complement System Proteins
Fibrinogen