Clinics Sao Paulo. 2016 Apr;714:199-204. doi: 10.6061/clinics/20160404.

Tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography: association with N categories.

Li H1Chen XL2Li JR3Li ZL3Chen TW4Pu H1Yin LL1Xu GH2Li ZW2Reng J2Zhou P2Cheng ZZ2Cao Y2.

Author information

  • 1Department of Radiology, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China.

  • 2Department of Radiology, Sichuan Cancer Hospital, Chengdu, Sichuan, China.

  • 3Department of Out-patient, West China Hospital of Sichuan University, Chengdu, Sichuan, China.

  • 4Sichuan Key Laboratory of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China.

Abstract

OBJECTIVE:

To determine whether the gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict the presence of regional lymph node metastasis and could determine N categories.

MATERIALS AND METHODS:

A total of 202 consecutive patients with gastric adenocarcinoma who had undergone gastrectomy 1 week after contrast-enhanced multidetector computed tomography were retrospectively identified. The gross tumor volume was evaluated on multidetector computed tomography images. Univariate and multivariate analyses were performed to determine whether the gross tumor volume could predict regional lymph node metastasis, and the Mann-Whitney U test was performed to compare the gross tumor volume among N categories. Additionally, a receiver operating characteristic analysis was performed to identify the accuracy of the gross tumor volume in differentiating N categories.

RESULTS:

The gross tumor volume could predict regional lymph node metastasis p<0.0001 in the univariate analysis, and the multivariate analyses indicated that the gross tumor volume was an independent risk factor for regional lymph node metastasis p=0.005, odds ratio=1.364. The Mann-Whitney U test showed that the gross tumor volume could distinguish N0 from the N1-N3 categories, N0-N1 from N2-N3, and N0-N2 from N3 all p<0.0001. In the T1-T4a categories, the gross tumor volume could differentiate N0 from the N1-N3 categories cutoff, 12.3 cm3, N0-N1 from N2-N3 cutoff, 16.6 cm3, and N0-N2 from N3 cutoff, 24.6 cm3. In the T4a category, the gross tumor volume could differentiate N0 from the N1-N3 categories cutoff, 15.8 cm3, N0-N1 from N2-N3 cutoff, 17.8 cm3, and N0-N2 from N3 cutoff, 24 cm3.

CONCLUSION:

The gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict regional lymph node metastasis and N categories.

PMID: 27166769 PMCID: PMC4825194 DOI: 10.6061/clinics/20160404

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