title: Usefulness of Two-Dimensional Values Measured Using Preoperative Multidetector Computed Tomography in Predicting Lymph Node Metastasis of Gastric Cancer.
abstract: BACKGROUND
  Multidetector computed tomography (MDCT) is essential for the prediction of lymph node (LN) metastasis in gastric cancer. However, the measurement method and size criteria for metastatic LNs using MDCT are unclear.
  
  
  METHODS
  MDCTs of gastric cancer patients who underwent surgery and had pathological staging were reviewed by radiologists. The two-dimensional cutoff values for LNs with suspected metastasis were calculated, and clinicopathological data were analyzed using those cutoff values.
  
  
  RESULTS
  The total number of enrolled patients was 327. The cutoff values of the maximal area with metastatic LNs were obtained significantly at stations 3, 4, and 6, and those values were 112.09, 33.79, and 85.88 mm(2), respectively. The common cutoff value was 112.09 mm(2), and the area under the curve was 0.617 (P = 0.002). The overall survival rate of the patients with LNs less than 112.09 mm(2) was significantly better than those with LNs greater than 112.09 mm(2) (P < 0.001). In multivariate analysis, the maximal LN area was an independent prognostic factor (adjusted hazard ratio, 1.697 [95% confidence interval 1.116-2.582]).
  
  
  CONCLUSIONS
  Using two-dimensional values for LNs measured by MDCT is a practical method of predicting metastatic LNs in gastric cancer. The maximal LN area value would be useful in both the preoperative staging and prognosis prediction of gastric cancer.
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Su Lim
authors.initials: SL
authors.lastname: Lee
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. painkiller9@catholic.ac.kr.|Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu-si, Gyenggi-Do, Korea. painkiller9@catholic.ac.kr.
authors.forename: Han Hong
authors.initials: HH
authors.lastname: Lee
authors.affiliation: Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Young Mi
authors.initials: YM
authors.lastname: Ku
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hae Myung
authors.initials: HM
authors.lastname: Jeon
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D009367:Neoplasm Staging; D011300:Preoperative Care; D011379:Prognosis; D012372:ROC Curve; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery