The Significance of Preoperative Computed Tomography Features in the Prediction of Overall Survival in Gastric Cancer: A Retrospective Analysis

Abstract

Objective: Computed tomography (CT) is a frequently used modality for staging in the preoperative evaluation of gastric cancer (GC). Our aim was to interpret the importance of preoperative CT features in predicting overall survival (OS) in patients operated for GC.Methods: 101 patients with GC (33 women, 68 men; range of age: 29-82 years, median age: 61 years) who had abdominal CT prior to surgical resection were included into the study retrospectively. Two radiologists evaluated CT scans to record the longest dimension of the tumor, the localization of the lesion, the attenuation values of the tumor in the arterial and venous phases (HUs), invasion depth of the lesion (T stage), and the number of pathological lymph nodes (N stage). Postoperative pathological results including resection (R0, R1), T stage, N stage, grade, histopathological subtype were documented. All CT-provided results and clinicopathological features associated with OS were analyzed by univariate, multivariate and receiver operator characteristics (ROC) analysis.Results: Multivariate analysis revealed that non of the CT features associated with the OS. After resection, the survival ratio was poor for the R1 and high-grade groups than for the R0 and low-grade groups (p: 0.001, p: 0.005 respectively). N stage and the longest dimension of the tumor on CT imaging truely estimated R1 resection status (AUC,0.697; sensitivity,63%; specificity, 88%, AUC,0.734; sensitivity,18%; specificity, 76% respectively).Conclusion: R1 resection status is associated with poor OS in GC. CT features, including the tumor's longest dimension and the number of pathological lymph nodes, can predict R1 resection status.Keywords:Computed tomography, gastric cancer, grade,radiology, resection,survival