Clinical significance of CT-defined minimal ascites in patients with gastric cancer.
OBJECTIVE
To study the clinical significance of minimal ascites, which was only defined by the CT and whose nature was not determined preoperatively, in the relationship with the peritoneal carcinomatosis.


METHODS
The medical records and the dynamic CT films of 118 patients with gastric cancer were reviewed. Factors associated with peritoneal carcinomatosis were analyzed in 40 patients who had CT-defined ascites of which the nature was surgically confirmed.


RESULTS
Only 12.5-25% of the CT-defined minimal ascites, whose volume was estimated to be less than 50 mL, were associated with peritoneal carcinomatosis. When the estimated CT-defined ascitic volume was 50 mL or more, peritoneal carcinomatosis was identified in 75-100%. When CT-defined lymph node enlargements were not found beyond the regional gastric area, perigastric invasions were not suspected, and the size of tumor was less than 3 cm, peritoneal carcinomatosis seemed significantly less accompanied at the univariate analysis. However, except for the minimal volume of CT-defined ascites in comparison with the mild or more, other factors were not confirmed multivariately.


CONCLUSIONS
In the patients with gastric cancer, CT-defined minimal ascites alone is rarely associated with peritoneal carcinomatosis, if it does not accompany other signs suggestive of malignant seeding. Therefore, consideration of active curative resection should not be hesitated, if CT-defined minimal ascites is the only delusive sign.
Chang
Dong Kyung
DK
Department of Internal Medicine, Seoul National University, Seoul, Korea. giwkim@hanmail.net
Kim
Ji Won
JW
Kim
Byung Kwan
BK
Lee
Kook Lae
KL
Song
Chi Sung
CS
Han
Joon Koo
JK
Song
In Sung
IS
D001201:Ascites / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000473:pathology* / Q000503:physiopathology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed