title: Clinical and diagnostic significance of preoperative computed tomography findings of ascites in patients with advanced gastric cancer.
abstract: BACKGROUND
  The relationship between ascites, as detected by preoperative computed tomography (CT), and peritoneal metastasis of gastric cancer requires clarification because of its likely significance for clinical outcome.
  
  
  METHODS
  A retrospective analysis of 293 patients with advanced gastric cancer investigated the association between preoperative CT findings of ascites and surgical findings of peritoneal washing cytology and peritoneal metastasis.
  
  
  RESULTS
  Forty-five of 293 patients (15%) presented with ascites on preoperative CT. Positive ascites on CT predicted the presence of free tumor cells with 40% sensitivity and 97% specificity, and peritoneal metastasis with 51% sensitivity and 97% specificity. Ascites on CT was an independent prognostic factor by univariate (P < .001) and multivariate (relative risk, 2.03; 95% confidence interval, 1.39-2.96; P < .001) analyses. The median survival time was 6.0 months in patients with positive ascites on CT.
  
  
  CONCLUSIONS
  The presence of ascites on CT suggests the presence of peritoneal metastasis and indicates a poor prognosis. The presence of peritoneal metastasis should be confirmed by diagnostic laparoscopy in gastric cancer patients with ascites.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Yajima
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Kanda
authors.forename: Manabu
authors.initials: M
authors.lastname: Ohashi
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Wakai
authors.forename: Satoru
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Ryuta
authors.initials: R
authors.lastname: Sasamoto
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000230:Adenocarcinoma / Q000150:complications* / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001201:Ascites / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000556:secondary / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D015996:Survival Rate; D014057:Tomography, X-Ray Computed