Jin Cheng1, Jing Wu1, Yingjiang Ye2, Chunfang Zhang3, Yinli Zhang4, Yi Wang5. 1. Department of Radiology, Peking University People's Hospital, 11 Xizhimen South St., Beijing, 100044, China. 2. Department of Gastrointestinal Surgery, Peking University People's Hospital, 11 Xizhimen South St., Beijing, 100044, China. 3. Clinical Epidemiology and Medical Statistics, Peking University People's Hospital, 11 Xizhimen South St., Beijing, 100044, China. 4. Department of Pathology, Peking University People's Hospital, 11 Xizhimen South St., Beijing, 100044, China. 5. Department of Radiology, Peking University People's Hospital, 11 Xizhimen South St., Beijing, 100044, China. wangyi@pkuph.edu.cn.
Abstract
PURPOSE: To determine the 1-year progression-free survival (PFS) of extramural venous invasion (EMVI), detected with contrast-enhanced multiple-row detector computed tomography (ceMDCT), in patients with stage III gastric cancer. METHODS: Between January 2009 and December 2013, 117 patients with pathological-proved stage III gastric cancer based on the criteria of the AJCC 7th were included in this retrospective study. All patients underwent adjuvant chemotherapy postoperatively and had been monitored with the follow-up chest/abdomen/pelvis ceMDCT on 3, 6, and 12 months post-operation. Two radiologists reviewed preoperative images regarding the presence of EMVI, categories of tumor and categories of lymph node. Conventional prognostic histological factors including pathological T/N status, tumor location/growth pattern, histological type/tumor differentiation, and tumor size were also recorded. Disease progression was defined as the presence of radiological or/and pathology-confirmed metachronous metastases, local recurrence, or gastric cancer-related death. The 1-year PFS for both EMVI-positive and EMVI-negative was calculated using the Kaplan-Meier product limit. Hazard ratios for 1-year PFS were generated using a Cox proportional hazard regression on ceMDCT tumor characteristics. RESULTS: The prevalence of EMVI detected with ceMDCT was 43.6% (51/117) in patients with stage III gastric cancer. The EMVI-positive patients had significantly lower 1-year PFS rates (45.1%), than the EMVI-negative patients (75.8%), (Log-rank test, P = 0.0008). In a Cox proportional hazards regression analysis, EMVI and tumor location/growth pattern were identified as independent prognostic factors of 1-year PFS with hazard ratio of 2.272 (95% CI 1.133-4.556, P = 0.021) and 1.982 (95% CI 1.040-3.780, P = 0.039), respectively. CONCLUSION: EMVI status, detected with ceMDCT, could be used to counsel patients regarding ongoing risks of metastatic disease, implications for surveillance, and systemic chemotherapy.
PURPOSE: To determine the 1-year progression-free survival (PFS) of extramural venous invasion (EMVI), detected with contrast-enhanced multiple-row detector computed tomography (ceMDCT), in patients with stage III gastric cancer. METHODS: Between January 2009 and December 2013, 117 patients with pathological-proved stage III gastric cancer based on the criteria of the AJCC 7th were included in this retrospective study. All patients underwent adjuvant chemotherapy postoperatively and had been monitored with the follow-up chest/abdomen/pelvis ceMDCT on 3, 6, and 12 months post-operation. Two radiologists reviewed preoperative images regarding the presence of EMVI, categories of tumor and categories of lymph node. Conventional prognostic histological factors including pathological T/N status, tumor location/growth pattern, histological type/tumor differentiation, and tumor size were also recorded. Disease progression was defined as the presence of radiological or/and pathology-confirmed metachronous metastases, local recurrence, or gastric cancer-related death. The 1-year PFS for both EMVI-positive and EMVI-negative was calculated using the Kaplan-Meier product limit. Hazard ratios for 1-year PFS were generated using a Cox proportional hazard regression on ceMDCTtumor characteristics. RESULTS: The prevalence of EMVI detected with ceMDCT was 43.6% (51/117) in patients with stage III gastric cancer. The EMVI-positive patients had significantly lower 1-year PFS rates (45.1%), than the EMVI-negative patients (75.8%), (Log-rank test, P = 0.0008). In a Cox proportional hazards regression analysis, EMVI and tumor location/growth pattern were identified as independent prognostic factors of 1-year PFS with hazard ratio of 2.272 (95% CI 1.133-4.556, P = 0.021) and 1.982 (95% CI 1.040-3.780, P = 0.039), respectively. CONCLUSION: EMVI status, detected with ceMDCT, could be used to counsel patients regarding ongoing risks of metastatic disease, implications for surveillance, and systemic chemotherapy.
Authors: I Mokadem; W P M Dijksterhuis; M van Putten; L Heuthorst; J M de Vos-Geelen; N Haj Mohammad; G A P Nieuwenhuijzen; H W M van Laarhoven; R H A Verhoeven Journal: Gastric Cancer Date: 2019-04-04 Impact factor: 7.370
Authors: Bo Gao; Caizhen Feng; Fan Chai; Shengcai Wei; Nan Hong; Yingjiang Ye; Yi Wang; Jin Cheng Journal: Cancer Med Date: 2021-09-12 Impact factor: 4.452