Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Diagnostic Value of Clinical T Staging Assessed by Endoscopy and Stomach Protocol Computed Tomography in Gastric Cancer: The Experience of a Low-Volume Institute

  • Kim, Tae Hyeon (Department of Surgery, Jeju National University School of Medicine) ;
  • Kim, Jeong Jae (Department of Radiology, Jeju National University School of Medicine) ;
  • Kim, Seung Hyoung (Department of Radiology, Jeju National University School of Medicine) ;
  • Kim, Bong Soo (Department of Radiology, Jeju National University School of Medicine) ;
  • Song, Hyun Joo (Department of Gastroenterology, Jeju National University School of Medicine) ;
  • Na, Soo Young (Department of Gastroenterology, Jeju National University School of Medicine) ;
  • Boo, Sun Jin (Department of Gastroenterology, Jeju National University School of Medicine) ;
  • Kim, Heung Up (Department of Gastroenterology, Jeju National University School of Medicine) ;
  • Maeng, Young Hee (Department of Pathology, Jeju National University School of Medicine) ;
  • Hyun, Chang Lim (Department of Pathology, Jeju National University School of Medicine) ;
  • Kim, Kwang Sig (Department of Surgery, Jeju National University School of Medicine) ;
  • Jeong, In Ho (Department of Surgery, Jeju National University School of Medicine)
  • Received : 2012.09.16
  • Accepted : 2012.10.08
  • Published : 2012.12.31
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Abstract

Purpose: Clinical staging of gastric cancer appears to be important more and more for tailored therapy. This study aimed to verify the accuracy of clinical T staging in a low-volume institute. Materials and Methods: We retrospectively reviewed prospectively collected data of gastric cancer patients who underwent resection. A total of 268 patients of gastric cancer were enrolled from March 2004 to June 2012. These demographics, tumor characteristics, and clinical stages were analyzed for identification of diagnostic value of clinical T staging. Results: The predictive values for pT1 of endoscopy and computed tomography were 90.0% and 89.4%, respectively. In detail, the predictive values of endoscopy for pT1a, pT1b, and pT2 or more were 87%, 58.5%, and 90.6%, respectively. The predictive values of computed tomography for pT1a, pT1b, and pT2 or more were 68.8%, 73.9%, and 84.4%, respectively. The factors leading to underestimation of pT2 or more lesions by gastroscopy were the middle third location, the size greater than 2 cm, and younger age. Those for overestimation of pT1 lesion by computed tomography were male, age more than 70 years, elevated type, and size greater than 3 cm. Conclusions: Diagnostic accuracy of early gastric cancer was 90%, which is comparable to those of high volume center. In patients with early gastric cancer, limited gastrectomy or minimal invasive surgery can be safely introduced at a low volume center also. However, the surgeon of low-volume institute should consider the accuracy of clinical staging before extending the indication of limited treatment.

Keywords

References

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