Rui-Jia Sun1, Lei Tang1, Xiao-Ting Li1, Zi-Yu Li2, Ying-Shi Sun3. 1. From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China. 2. From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Surgery, Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China. 3. From Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital and Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing, 100142, China. sys27@163.com.
Abstract
PURPOSE: To investigate the correlation between the preoperative CT findings in diagnosis of gastric bare area (GBA) invasion and the 3-year-overall survival (OS) of patients with proximal gastric carcinoma (PGC). METHODS: 108 consecutive patients with PGC confirmed by biopsy underwent MDCT scan prior to gastrectomy were enrolled retrospectively from Dec 2009 to Dec 2014. GBA invasion in PGC were evaluated by measuring the direct CT signs including transmural involvement and lymph nodes in the GBA. The indirect signs were also evaluated including the infiltration of the diaphragm, gastrophrenic ligament and perigastric fat. Kaplan-Meier estimates with log-rank test and Cox proportional hazard model were used for analysis. RESULTS: The two raters achieved excellent agreement. Univariate Kaplan-Meier estimates indicated that postoperative chemotherapy (p = 0.003), transmural involvement (p < 0.001), lymph nodes in the GBA (p = 0.015) and cT staging (p = 0.002) were associated with OS. Cox proportional hazard model indicated that the transmural involvement (HR = 8.194, 95% CI 2.15-31.266), diaphragm involvement (HR = 0.21, 95% CI 0.042-0.986), perigastric fat infiltration (HR = 0.125, 95% CI 0.018-0.885; HR = 0.02, 95% CI 0.001-0.264), and cT staging were independent prognostic factors for OS. CONCLUSION: CT findings of GBA invasion in patients with PGC, not only the transmural involvement but also the indirect signs are independent prognostic factors potentially, which should be given more emphasis in future clinical practice.
PURPOSE: To investigate the correlation between the preoperative CT findings in diagnosis of gastric bare area (GBA) invasion and the 3-year-overall survival (OS) of patients with proximal gastric carcinoma (PGC). METHODS: 108 consecutive patients with PGC confirmed by biopsy underwent MDCT scan prior to gastrectomy were enrolled retrospectively from Dec 2009 to Dec 2014. GBA invasion in PGC were evaluated by measuring the direct CT signs including transmural involvement and lymph nodes in the GBA. The indirect signs were also evaluated including the infiltration of the diaphragm, gastrophrenic ligament and perigastric fat. Kaplan-Meier estimates with log-rank test and Cox proportional hazard model were used for analysis. RESULTS: The two raters achieved excellent agreement. Univariate Kaplan-Meier estimates indicated that postoperative chemotherapy (p = 0.003), transmural involvement (p < 0.001), lymph nodes in the GBA (p = 0.015) and cT staging (p = 0.002) were associated with OS. Cox proportional hazard model indicated that the transmural involvement (HR = 8.194, 95% CI 2.15-31.266), diaphragm involvement (HR = 0.21, 95% CI 0.042-0.986), perigastric fat infiltration (HR = 0.125, 95% CI 0.018-0.885; HR = 0.02, 95% CI 0.001-0.264), and cT staging were independent prognostic factors for OS. CONCLUSION: CT findings of GBA invasion in patients with PGC, not only the transmural involvement but also the indirect signs are independent prognostic factors potentially, which should be given more emphasis in future clinical practice.
Authors: Jang Kyu Choi; Young Suk Park; Do Hyun Jung; Sang Yong Son; Sang Hoon Ahn; Do Joong Park; Hyung Ho Kim Journal: J Gastric Cancer Date: 2015-09-30 Impact factor: 3.720