Clinical Research Papers:
CT volumetry for gastric adenocarcinoma: association with lymphovascular invasion and T-stages
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Abstract
Xiao-Li Chen1,*, Hong Pu2, Long-Lin Yin2, Jun-Ru Li3,*, Zhen-Lin Li4, Guang-Wen Chen2, Neng-Yi Hou5 and Hang Li2
1Department of Radiology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, Sichuan, China
2Department of Radiology, Affiliated Hospital of Medical School, University of Electronic Science and Technology of China, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, Sichuan, China
3Department of Out-Patient, West China Hospital of Sichuan University, Chengdu, Sichuan, China
4Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China
5Department of Gastrointestinal Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Qingyang District, Chengdu, Sichuan, China
*These authors contributed equally to this work.
Correspondence to:
Hang Li, email: [email protected]
Hong Pu, email: [email protected]
Keywords: gastric adenocarcinoma; lymphovascular invasion; T-stages; MDCT; gross tumor volume
Received: July 27, 2017 Accepted: October 13, 2017 Published: December 15, 2017
ABSTRACT
Purpose: To determine whether gross tumor volume of resectable gastric adenocarcinoma on multidetector computed tomography could predict presence of lymphovascular invasion and T-stages.
Results: Gross tumor volume increased with the lymphovascular invasion (r = 0.426, P < 0.0001) and T stage (r = 0.656, P < 0.0001). Univariate analysis showed gross tumor volume could predict lymphovascular invasion ( P < 0.0001). Multivariate analyses indicated gross tumor volume as an independent risk factor of lymphovascular invasion ( P = 0.026, odds ratio = 2.284). The Mann-Whitney U test showed gross tumor volume could distinguish T2 from T3, T1 from T2–T4a, T1–T2 from T3–T4a and T1–T3 from T4a ( P = 0.000). In the development cohort, gross tumor volume could predict lymphovascular invasion (cutoff, 15.92 cm3; AUC, 0.760), and distinguish T2 from T3 (cutoff, 10.09 cm3; AUC, 0.828), T1 from T2-T4a (cutoff, 8.20 cm3; AUC, 0.860), T1-T2 from T3-T4a (cutoff, 15.88 cm3; AUC, 0.883), and T1-T3 from T4a (cutoff, 21.53 cm3; AUC, 0.834). In validation cohort, gross tumor volume could predict presence of lymphovascular invasion (AUC, 0.742), and distinguish T2 from T3 (AUC, 0.861), T1 from T2-T4a (AUC, 0.859), T1–T2 from T3–T4a (AUC, 0.875), and T1–T3 from T4a (AUC, 0.773).
Materials and Methods: 360 consecutive patients with gastric adenocarcinoma were retrospectively identified. Gross tumor volume was evaluated on multidetector computed tomography images. Statistical analysis was performed to determine whether gross tumor volume could predict presence of lymphovascular invasion and T-stages. Cutoffs of gross tumor volume were first investigated in 212 patients and then validated in an independent 148 patients using area under the receiver operating characteristic curve (AUC) for predicting lymphovascular invasion and T-stages.
Conclusions: Gross tumor volume of resectable gastric adenocarcinoma at multidetector computed tomography demonstrated capability in predicting lymphovascular invasion and distinguishing T-stages.
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