华西医院李真林 Tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography: association with N categories.

Clinics （Sao Paulo）. 2016 Apr;71（4）:199-204. doi: 10.6061/clinics/2016（04）04.

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

Li H¹, Chen XL², Li JR³, Li ZL³, Chen TW⁴, Pu H¹, Yin LL¹, Xu GH², Li ZW², Reng J², Zhou P², Cheng ZZ², Cao 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/2016（04）04