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KMID : 0614620170700010021
Korean Journal of Gastroenterology
2017 Volume.70 No. 1 p.21 ~ p.26
The Value of Computed Tomography in Preoperative N Staging of Early Gastric Cancer Meeting the Endoscopic Resection Criteria
Kim Su-Jin

Kim Tae-Un
Choi Cheol-Woong
Kang Dae-Hwan
Kim Hyung-Wook
Park Su-Bum
Nam Hyeong-Seok
Ryu Dae-Gon
Abstract
Background/Aims: This study evaluated the value of abdominal computed tomography (CT) in preoperative N staging of early gastric cancers (EGCs) within standard and expanded indications of endoscopic resection (ER) and investigated the factors affecting accuracy.

Methods: Between March 2009 and March 2016, a total of 268 patients with EGC within the standard and expanded indications of ER underwent preoperative abdominal CT and surgical gastrectomy with lymph node (LN) dissection. Preoperative N staging of CT was compared with the pathologic result.

Results: The accuracy of N staging for EGCs within the standard and expanded indications was 86.1% (235/268). There was no LN metastasis in patients with cN1 in CT staging. LN metastasis was found in 7 patients with EGCs that met the expanded ER indication and cN0 in CT staging. According to the univariate analysis, ulcers, including scars, were associated with the false positive of lymph node metastasis in abdominal CT (odds ratio 3.56; 95% confidence interval 1.56-8.15).

Conclusions: The present study suggests that the value of abdominal CT is limited for nodal staging of EGCs that meet the ER indication.
KEYWORD
Gastric cancer, Multidetector computed tomography, Lymphatic metastasis
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