PRE-OPERATIVE EVALUATION AND TUMOUR-NODE-METASTASIS STAGING OF GASTRIC CARCINOMA USING 16 SLICE MULTIDETECTOR-ROW COMPUTED TOMOGRAPHY

Main Article Content

Zeenat Adil
Sidrah Saeed

Abstract

OBJECTIVE: To evaluate pre-operative tumour-node-metastasis staging (TNM) staging, metastases status and detection of role of multidetector-row computed tomography (MDCT) in gastric carcinoma patients in Pakistan.


METHODS: This cross-sectional study, spanned over 14 months (January 2018-February 2019), was conducted at Radiology Department of Kuwait Teaching Hospital. Sample size was 173. Patients, selected through non-probability consecutive sampling technique, irrespective of gender, aged over 18 years and having clinically and histopathologically diagnosed with gastric carcinoma were included in the study. MDCT of patients was done. SPSS Version-24 was utilized for data analysis. Chi-square test was applied with p-value ≤0.05 was considered significant.


RESULTS: Out of total 173 patients with gastric carcinoma, 121 (69.9%) were males and 52 (30.1%) were females. Mean age of patients was 48.5±1.2 years. Majority of patients were in T4a stage (n=64; 37%) followed T4b, T3, T0, T1 & T2 (24.9%, 17.3%, 11% and 9.8%) respectively.  N0 stage with no nodal metastases was 40.5% followed by N1 stage (1-2 lymph nodes), N2 stage (3-6 lymph nodes), N3a stage (7-15 lymph nodes) and N3b stage (more than 15 lymph nodes) with 25.4%, 19.7%, 5.8% and 8.7% respectively. M1 stage with distant metastases was in 76 (43.9%) patients. Age and gender had insignificant association with TNM system (p>0.05).


CONCLUSION: Multi detector row computed tomography was effective in pre-operative evaluation and TNM staging of gastric carcinoma. Lymph node detection on MDCT can further be utilized for fine needle biopsies if required.

Article Details

How to Cite
Adil, Z., and S. Saeed. “PRE-OPERATIVE EVALUATION AND TUMOUR-NODE-METASTASIS STAGING OF GASTRIC CARCINOMA USING 16 SLICE MULTIDETECTOR-ROW COMPUTED TOMOGRAPHY”. KHYBER MEDICAL UNIVERSITY JOURNAL, Vol. 13, no. 3, Sept. 2021, pp. 147-51, doi:10.35845/kmuj.2021.20680.
Section
Original Articles

References

1. Parkin DM, Bray F, Ferlay J. Global cancer statistics, 2002. CA Cancer J Clin 2005;55(2):74-108.
2. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010;17(3):1471-4.
3. Torre LA, Bray F, Siegel RL. Global cancer statistics, 2012. CA Cancer J Clin 2015;12(1):154-6.
4. Daniyal A, Ahmad S, Ahmad M, Asif MH, Akram M, Rehman US, et al. Risk factors and epidemiology of gastric cancer in Pakistan. Asian Pac J Cancer Prev 2015; 16(12):4821-24.
5. Dixon M, Cardoso R, Tinmouth J. What studies are appropriate and necessary for staging gastric adenocarcinoma? Results of an international RAND/UCLA expert panel. Gastric Cancer 2014;17(3):377–82.
6. Kierszenbaum ML, von Atzingen AC, Tiferes DA, Alvim MV, Lopes GD, Matos D, et al. Colonografia por tomografia computadorizada na visão do médico encaminhador: qual o seu valor segundo a visão de especialistas? Radiol Bras 2014;47(3):135–140.
7. Maciel AC, Maciel LC. Colonografia por tomografia computadorizada: um método de rastreamento conhecido porém pouco utilizado. Radiol Bras 2014;47(3):5–6.
8. Barros RHO, Penachim TJ, Martins DL. Tomografia computadorizada de múltiplos detectores no estadiamento pré-operatório do adenocarcinoma gástrico. Radiol Bras 2015;48(2):74–80.
9. Santana PJ, Júnior, Aurione ACV, Dangoni R. Tumor neuroendócrino gástrico tipo III. Radiol Bras 2014;47(4):11-13.
10. Monjardim RF, Costa DMC, Romano RFT, Diagnóstico da esteatose hepática pela tomografia computadorizada de abdome com meio de contraste intravenoso. Radiol Bras 2013;46(3):134–138.
11. Salvadori PS, Costa DMC, Romano RFT. Quando a fase de equilíbrio pode ser suprimida nos exames de tomografia computadorizada de abdome? Radiol Bras 2013;46(2):65–70.
12. Costa DM, Salvadori PS, Monjardim RD, Bretas EA, Torres LR, Caldana RP, et al. Quando a fase sem contraste intravenoso é desnecessária nos exames de tomografia computadorizada do abdome? Análise retrospectiva de 244 casos. Radiol Bras 2013;46(3):197–202.
13. Teixeira AC, Torres UD, Westin CE, Oliveira EP, Gual F, Cardoso LV, et al. Tomografia computadorizada com multidetectores no diagnóstico pré-operatório das complicações intestinais causadas pela ingestão de corpos estranhos da dieta sem suspeita clínica: série de casos enfatizando o uso de técnicas de renderização volumétrica. Radiol Bras 2013;46(2):346–50.
14. Washington K. 7th edition of the AJCC cancer staging manual: stomach. Ann Surg Oncol 2010;17(4):3077–9.
15. Lee IJ, Lee JM, Kim SH, Heo SH, Han SM, Chen K, et al. Diagnostic performance of 64-channel multidetector CT in the evaluation of gastric cancer: differentiation of mucosal cancer (T1a) from submucosal involvement (T1b and T2). Radiology 2010;255(4):805-14. https://doi.org/10.1148/radiol.10091313.
16. Shen Y, Kang HK, Jeong YY. Evaluation of early gastric cancer at multidetector CT with multiplanar reformation and virtual endoscopy. Radiographics 2011;31(4):189-99. https://doi.org/10.1148/rg.311105502.
17. Pan Z, Pang L, Ding B, Yan C, Zhang H, Du L, et al. Gastric cancer staging with dual energy spectral CT imaging. PLoS One 2013;8(1):123-5. https://doi.org/10.1371/journal.pone.0053651.
18. Coburn N, Seevaratnam R, Paszat L. Optimal management of gastric cancer: results from an international RAND/UCLA expert panel. Ann Surg 2014;259(2):102–8. https://doi.org/10.1097/SLA.0b013e318288dd2b.
19. Takeuchi H, Kitagawa Y. Sentinel lymph node biopsy in gastric cancer. J Clin Oncol 2013 Oct 10;31(29):3704-10. https://doi.org/10.1200/JCO.2013.50.3789.
20. Furukawa K, Miyahara R, Itoh A, Ohmiya N, Hirooka Y, Mori K, et al. Diagnosis of the invasion depth of gastric cancer using MDCT with virtual gastroscopy: comparison with staging with endoscopic ultrasound. AJR Am J Roentgenol 2011 Oct;197(4):867-75. https://doi.org/10.2214/AJR.10.5872.
21. Zytoon AA, El-Atfey SI, Hassanein SA. Diagnosis of gastric cancer by MDCT gastrography: diagnostic characteristics and management potential. Egypt J Radiol Nucl Med 2020 Dec;51(1):1-7. https://doi.org/10.1186/s43055-020-0148-y.
22. Sharara SM, Nagi MA, Soliman SS. Multidetector computed tomography in the evaluation of gastric malignancy; A multicenteric study. Egypt J Radiol Nucl Med 2018 Jun 1;49(2):304-9. https://doi.org/10.1016/j.ejrnm.2018.02.012.
23. Emam HM, Moussa EM, Abouelmaged M, Ibrahim MR. Role of multidetector CT in staging of gastric carcinoma. J Cancer Ther 2019 Jul 8;10(7):565-79. https://doi.org/10.4236/jct.2019.107046.
24. Teama AH, El-Badry AM, Yousef ES. The role of multislice computed tomography in the diagnosis of gastric malignant tumors. Tanta Med J 2016 Jul 1;44(3):119. https://doi.org/10.4103/1110-1415.198480.