title: Nodal counts on MDCT as a surrogate marker for surgical curability in gastric cancer.
abstract: BACKGROUND
  Thin-slice multidetector row computed tomography (MDCT) has emerged as a promising diagnostic modality in various cancers. This study was designed to evaluate the utility of metastatic nodal counts on MDCT as a surrogate maker for surgical curability in gastric cancer.
  
  
  METHODS
  Between 2005 and 2007, a total of 92 patients with gastric cancer underwent preoperative MDCT at a slice thickness of 1.0 mm at our hospital. All regional lymph nodes showing metastatic involvement were preoperatively counted.
  
  
  RESULTS
  Although the total counts of metastatic lymph nodes on MDCT were significantly smaller than those found by histopathology (P = 0.00001), there was a significant correlation between nodal counts on MDCT and histopathology by Spearman's analysis [P < 0.0001, pathologic counts = 1.63x (counts on MDCT) + 2.5]. Nodal counts on MDCT of ≥4 were analyzed as putative pathologic nodal counts of ≥8 by the equation, and pathologic metastatic nodal counts of ≥8 were most significantly correlated with noncurative resection (P < 0.0001). According to the logistic regression analysis, nodal counts on MDCT of ≥4 were a significant independent variable for noncurative resection (P = 0.0052, odds ratio 26.68). Nodal counts on MDCT of ≥4 could distinguish noncurative patients from curative patients with 94.4% sensitivity and 71.6% specificity.
  
  
  CONCLUSIONS
  Nodal counts on MDCT could be a reliable surrogate maker for surgical curability of gastric cancer. This marker might enable us to select prospective candidates for additional or alternative treatments in gastric cancer.
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Murayama
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ikoma
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Nakanishi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Ochiai
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Kokuba
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D015415:Biomarkers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D061330:Multidetector Computed Tomography; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery
chemical_list: D015415:Biomarkers