Diagnostic value of clinical T staging assessed by endoscopy and stomach protocol computed tomography in gastric cancer: the experience of a low-volume institute.
OBJECTIVE
Clinical staging of gastric cancer appears to be important more and more for tailored therapy. This study aimed to verify the accuracy of clinical T staging in a low-volume institute.


METHODS
We retrospectively reviewed prospectively collected data of gastric cancer patients who underwent resection. A total of 268 patients of gastric cancer were enrolled from March 2004 to June 2012. These demographics, tumor characteristics, and clinical stages were analyzed for identification of diagnostic value of clinical T staging.


RESULTS
The predictive values for pT1 of endoscopy and computed tomography were 90.0% and 89.4%, respectively. In detail, the predictive values of endoscopy for pT1a, pT1b, and pT2 or more were 87%, 58.5%, and 90.6%, respectively. The predictive values of computed tomography for pT1a, pT1b, and pT2 or more were 68.8%, 73.9%, and 84.4%, respectively. The factors leading to underestimation of pT2 or more lesions by gastroscopy were the middle third location, the size greater than 2 cm, and younger age. Those for overestimation of pT1 lesion by computed tomography were male, age more than 70 years, elevated type, and size greater than 3 cm.


CONCLUSIONS
Diagnostic accuracy of early gastric cancer was 90%, which is comparable to those of high volume center. In patients with early gastric cancer, limited gastrectomy or minimal invasive surgery can be safely introduced at a low volume center also. However, the surgeon of low-volume institute should consider the accuracy of clinical staging before extending the indication of limited treatment.
Department of Surgery, Jeju National University School of Medicine, Jeju, Korea.
Tae Hyeon
TH
Kim
Jeong Jae
JJ
Kim
Seung Hyoung
SH
Kim
Bong Soo
BS
Kim
Hyun Joo
HJ
Song
Soo Young
SY
Na
Sun Jin
SJ
Boo
Heung Up
HU
Kim
Young Hee
YH
Maeng
Chang Lim
CL
Hyun
Kwang Sig
KS
Kim
In Ho
IH
Jeong
Gastroscopy; Neoplasm staging; Stomach neoplasms; Technology, radiologic