Clinical surgery–internationalClinical and diagnostic significance of preoperative computed tomography findings of ascites in patients with advanced gastric cancer
Section snippets
Patients
A total of 413 patients with the clinical diagnosis of gastric cancer of tumor depth T2, T3, and T4 underwent surgery at the Niigata University Medical Hospital between April 1988 and December 2002. We excluded from the analysis 64 patients with a second primary malignant tumor in another organ (eg, esophageal cancer, colorectal cancer, or hepatocellular carcinoma), 20 patients who were not examined by CT, 8 patients who did not undergo peritoneal washing cytology at laparotomy, and 28 patients
Clinical and surgical outcomes
Forty-five of the 293 patients (15.3%) presented with ascites on preoperative CT (Table 1). Their ages ranged from 29 to 85 years (median, 57.0 y). Twenty patients were men and 25 were women. For these patients with positive ascites on CT, residual tumor status was following; there was no residual tumor (R0) in 1 patient, microscopic residual tumor (R1) in 3 patients, and macroscopic residual tumor (R2) in 41 patients. Surgery included curative or palliative gastrectomy in 25 patients,
Discussion
The clinical validity of CT-based diagnosis of peritoneal metastasis is controversial because there is a wide range in the reported sensitivity (range, 27–100%) and specificity (68–100%) [4], [5], [6], [7], [8], [9], [10]. Variation in the diagnostic usefulness of CT for peritoneal metastasis presumably is caused in part by patient background, which differs between nations and institutions. In addition, it may be caused by differences in the features chosen as indicators of peritoneal
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Cited by (58)
High prevalence of peritoneal metastasis in gastric cancer presenting gastric outlet obstruction: A new candidate for consecutive diagnostic staging laparoscopy and laparoscopic gastrojejunostomy
2022, European Journal of Surgical OncologyCitation Excerpt :The current study revealed that the presence of ascites, large type 3 or type 4 tumors, and gastric angle involvement were associated with peritoneal metastasis in cM0 GC-GOO patients. The correlation between peritoneal metastasis and ascites [17–19] or large type 3 or type 4 tumors [12,16] is well known and was found to be the same in GC-GOO. The high specificity of ascites and large type 3 or type 4 tumors may be the validation required to highly recommend DSL.
Gastric Carcinoma
2022, Oncologic Imaging: A Multidisciplinary ApproachPrognostic significance of peritoneal lavage cytology at three cavities in patients with gastric cancer
2015, Surgery (United States)Citation Excerpt :Using these criteria, CY at 3 cavities would be avoided in 554 (53%) of the 1,039 patients in this study. Our previous investigation demonstrated that positive ascites on computed tomography predicted the positive peritoneal cytology with 40% sensitivity and 97% specificity.20 Stratification by endoscopic ultrasound and computed tomography may aid in the selection of patients who do not require CY at 3 cavities or staging laparoscopy.