High accuracy of multislices computed tomography (MSCT) for para-aortic lymph node metastases from gastric cancer

A prospective single-center study

Daniele Marrelli, Maria Antonietta Mazzei, Corrado Pedrazzani, Marianna Di Martino, Carla Vindigni, Giovanni Corso, Eleonora Morelli, Luca Volterrani, Franco Roviello

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Background: The purpose of this study is to analyze the diagnostic accuracy of MSCT in the identification of para-aortic lymph node metastases from gastric cancer. Methods: A total of 92 consecutive patients with primary gastric cancer were prospectively submitted to preoperative MSCT staging according to a standard protocol in the period 2003-2010. All diagnostic procedures were performed by dedicated radiologists who were unaware of the final pathological nodal status. Subsequently all patients underwent potentially curative (R0) resection with extended lymphadenectomy plus para-aortic nodal dissection. Lymph node mapping in different stations and retrieval of single lymph nodes were performed by the surgeon on the fresh specimen and then submitted for pathological examination. Clinical, radiological, and pathological data were prospectively stored on database. Results: A median number of 47 (range: 18-114) total lymph nodes and 7 (range: 3-29) para-aortic lymph nodes were removed. In 13 of 92 included patients (14%), histological examination demonstrated para-aortic nodal metastases; MSCT was correctly positive in 11 of these cases (sensitivity: 85%). In 79 patients para-aortic nodes were not involved, and MSCT resulted correctly negative in 75 of these patients (specificity: 95%). Positive (PPV) and negative (NPV) predictive values were 73 and 97%, with a global accuracy of 93%. Conclusions: MSCT performed according to a standard protocol by dedicated radiologists demonstrated high accuracy in preoperative identification of para-aortic nodal metastases from gastric cancer. These results may be useful in planning surgical approach or during clinical staging before neoadjuvant chemotherapy.

Original languageEnglish
Pages (from-to)2265-2272
Number of pages8
JournalAnnals of Surgical Oncology
Volume18
Issue number8
DOIs
Publication statusPublished - Aug 2011

Fingerprint

Multidetector Computed Tomography
Stomach Neoplasms
Lymph Nodes
Neoplasm Metastasis
Lymph Node Excision
Dissection
Databases
Drug Therapy

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

High accuracy of multislices computed tomography (MSCT) for para-aortic lymph node metastases from gastric cancer : A prospective single-center study. / Marrelli, Daniele; Mazzei, Maria Antonietta; Pedrazzani, Corrado; Di Martino, Marianna; Vindigni, Carla; Corso, Giovanni; Morelli, Eleonora; Volterrani, Luca; Roviello, Franco.

In: Annals of Surgical Oncology, Vol. 18, No. 8, 08.2011, p. 2265-2272.

Research output: Contribution to journalArticle

Marrelli, D, Mazzei, MA, Pedrazzani, C, Di Martino, M, Vindigni, C, Corso, G, Morelli, E, Volterrani, L & Roviello, F 2011, 'High accuracy of multislices computed tomography (MSCT) for para-aortic lymph node metastases from gastric cancer: A prospective single-center study', Annals of Surgical Oncology, vol. 18, no. 8, pp. 2265-2272. https://doi.org/10.1245/s10434-010-1541-y
Marrelli, Daniele ; Mazzei, Maria Antonietta ; Pedrazzani, Corrado ; Di Martino, Marianna ; Vindigni, Carla ; Corso, Giovanni ; Morelli, Eleonora ; Volterrani, Luca ; Roviello, Franco. / High accuracy of multislices computed tomography (MSCT) for para-aortic lymph node metastases from gastric cancer : A prospective single-center study. In: Annals of Surgical Oncology. 2011 ; Vol. 18, No. 8. pp. 2265-2272.
@article{15d586b287e04708933adcbf659b0a28,
title = "High accuracy of multislices computed tomography (MSCT) for para-aortic lymph node metastases from gastric cancer: A prospective single-center study",
abstract = "Background: The purpose of this study is to analyze the diagnostic accuracy of MSCT in the identification of para-aortic lymph node metastases from gastric cancer. Methods: A total of 92 consecutive patients with primary gastric cancer were prospectively submitted to preoperative MSCT staging according to a standard protocol in the period 2003-2010. All diagnostic procedures were performed by dedicated radiologists who were unaware of the final pathological nodal status. Subsequently all patients underwent potentially curative (R0) resection with extended lymphadenectomy plus para-aortic nodal dissection. Lymph node mapping in different stations and retrieval of single lymph nodes were performed by the surgeon on the fresh specimen and then submitted for pathological examination. Clinical, radiological, and pathological data were prospectively stored on database. Results: A median number of 47 (range: 18-114) total lymph nodes and 7 (range: 3-29) para-aortic lymph nodes were removed. In 13 of 92 included patients (14{\%}), histological examination demonstrated para-aortic nodal metastases; MSCT was correctly positive in 11 of these cases (sensitivity: 85{\%}). In 79 patients para-aortic nodes were not involved, and MSCT resulted correctly negative in 75 of these patients (specificity: 95{\%}). Positive (PPV) and negative (NPV) predictive values were 73 and 97{\%}, with a global accuracy of 93{\%}. Conclusions: MSCT performed according to a standard protocol by dedicated radiologists demonstrated high accuracy in preoperative identification of para-aortic nodal metastases from gastric cancer. These results may be useful in planning surgical approach or during clinical staging before neoadjuvant chemotherapy.",
author = "Daniele Marrelli and Mazzei, {Maria Antonietta} and Corrado Pedrazzani and {Di Martino}, Marianna and Carla Vindigni and Giovanni Corso and Eleonora Morelli and Luca Volterrani and Franco Roviello",
year = "2011",
month = "8",
doi = "10.1245/s10434-010-1541-y",
language = "English",
volume = "18",
pages = "2265--2272",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York LLC",
number = "8",

}

TY - JOUR

T1 - High accuracy of multislices computed tomography (MSCT) for para-aortic lymph node metastases from gastric cancer

T2 - A prospective single-center study

AU - Marrelli, Daniele

AU - Mazzei, Maria Antonietta

AU - Pedrazzani, Corrado

AU - Di Martino, Marianna

AU - Vindigni, Carla

AU - Corso, Giovanni

AU - Morelli, Eleonora

AU - Volterrani, Luca

AU - Roviello, Franco

PY - 2011/8

Y1 - 2011/8

N2 - Background: The purpose of this study is to analyze the diagnostic accuracy of MSCT in the identification of para-aortic lymph node metastases from gastric cancer. Methods: A total of 92 consecutive patients with primary gastric cancer were prospectively submitted to preoperative MSCT staging according to a standard protocol in the period 2003-2010. All diagnostic procedures were performed by dedicated radiologists who were unaware of the final pathological nodal status. Subsequently all patients underwent potentially curative (R0) resection with extended lymphadenectomy plus para-aortic nodal dissection. Lymph node mapping in different stations and retrieval of single lymph nodes were performed by the surgeon on the fresh specimen and then submitted for pathological examination. Clinical, radiological, and pathological data were prospectively stored on database. Results: A median number of 47 (range: 18-114) total lymph nodes and 7 (range: 3-29) para-aortic lymph nodes were removed. In 13 of 92 included patients (14%), histological examination demonstrated para-aortic nodal metastases; MSCT was correctly positive in 11 of these cases (sensitivity: 85%). In 79 patients para-aortic nodes were not involved, and MSCT resulted correctly negative in 75 of these patients (specificity: 95%). Positive (PPV) and negative (NPV) predictive values were 73 and 97%, with a global accuracy of 93%. Conclusions: MSCT performed according to a standard protocol by dedicated radiologists demonstrated high accuracy in preoperative identification of para-aortic nodal metastases from gastric cancer. These results may be useful in planning surgical approach or during clinical staging before neoadjuvant chemotherapy.

AB - Background: The purpose of this study is to analyze the diagnostic accuracy of MSCT in the identification of para-aortic lymph node metastases from gastric cancer. Methods: A total of 92 consecutive patients with primary gastric cancer were prospectively submitted to preoperative MSCT staging according to a standard protocol in the period 2003-2010. All diagnostic procedures were performed by dedicated radiologists who were unaware of the final pathological nodal status. Subsequently all patients underwent potentially curative (R0) resection with extended lymphadenectomy plus para-aortic nodal dissection. Lymph node mapping in different stations and retrieval of single lymph nodes were performed by the surgeon on the fresh specimen and then submitted for pathological examination. Clinical, radiological, and pathological data were prospectively stored on database. Results: A median number of 47 (range: 18-114) total lymph nodes and 7 (range: 3-29) para-aortic lymph nodes were removed. In 13 of 92 included patients (14%), histological examination demonstrated para-aortic nodal metastases; MSCT was correctly positive in 11 of these cases (sensitivity: 85%). In 79 patients para-aortic nodes were not involved, and MSCT resulted correctly negative in 75 of these patients (specificity: 95%). Positive (PPV) and negative (NPV) predictive values were 73 and 97%, with a global accuracy of 93%. Conclusions: MSCT performed according to a standard protocol by dedicated radiologists demonstrated high accuracy in preoperative identification of para-aortic nodal metastases from gastric cancer. These results may be useful in planning surgical approach or during clinical staging before neoadjuvant chemotherapy.

UR - http://www.scopus.com/inward/record.url?scp=80051551079&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051551079&partnerID=8YFLogxK

U2 - 10.1245/s10434-010-1541-y

DO - 10.1245/s10434-010-1541-y

M3 - Article

VL - 18

SP - 2265

EP - 2272

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 8

ER -