Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?

Aim. Gastrectomy with lymph node dissection is standard treatment in gastric cancer. This study aimed to explore whether preoperative investigation finds could predict lymph node metastatic scope in gastric carcinoma so that the optimal surgical procedure could be selected. Materials and Methods. Ra...

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Main Authors: Jia-Le Zhang, Zhen-Ning Wang, Hui-Mian Xu, Zhi Zhu, Bao-Jun Huang
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/4914201
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author Jia-Le Zhang
Zhen-Ning Wang
Hui-Mian Xu
Zhi Zhu
Bao-Jun Huang
author_facet Jia-Le Zhang
Zhen-Ning Wang
Hui-Mian Xu
Zhi Zhu
Bao-Jun Huang
author_sort Jia-Le Zhang
collection DOAJ
description Aim. Gastrectomy with lymph node dissection is standard treatment in gastric cancer. This study aimed to explore whether preoperative investigation finds could predict lymph node metastatic scope in gastric carcinoma so that the optimal surgical procedure could be selected. Materials and Methods. Radical gastrectomy patients (n=378) were separated into two groups according to the lymph node metastatic scope. Univariate and multivariate analyses of preoperative examination results were performed to identify the predictors of metastatic scope. ROC curves were constructed, and the area under the curve (AUC) was calculated to estimate diagnostic values. Results. Serum CEA (OR: 3.73; 95% CI: 1.84–7.56; P≤0.001), tumor size (OR: 2.07; 95% CI: 1.08–3.98; P=0.03), and CT examination results (OR: 17.81; 95% CI: 9.18–34.55; P≤0.001) were identified as independent predictors. The AUC proved that they possessed significant diagnostic value. When CT examination was negative, the combination of serum CEA and tumor size showed high specificity (95.3%; 164/172), negative predictive value (92.7%; 164/177), and accuracy (89.0%; 170/191). Conclusions. Preoperative serum CEA, tumor size, and CT examination are independent predictors of lymph node metastatic scope and can be used for selecting the appropriate lymphadenectomy pattern in gastric cancer patients.
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spelling doaj-art-c2e86bec1f65442d88cc2e327b43e29d2025-02-03T05:45:22ZengWileyGastroenterology Research and Practice1687-61211687-630X2018-01-01201810.1155/2018/49142014914201Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?Jia-Le Zhang0Zhen-Ning Wang1Hui-Mian Xu2Zhi Zhu3Bao-Jun Huang4Department of Surgical Oncology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, ChinaDepartment of Surgical Oncology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, ChinaDepartment of Surgical Oncology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, ChinaDepartment of Surgical Oncology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, ChinaDepartment of Surgical Oncology, First Affiliated Hospital, China Medical University, Shenyang, Liaoning, ChinaAim. Gastrectomy with lymph node dissection is standard treatment in gastric cancer. This study aimed to explore whether preoperative investigation finds could predict lymph node metastatic scope in gastric carcinoma so that the optimal surgical procedure could be selected. Materials and Methods. Radical gastrectomy patients (n=378) were separated into two groups according to the lymph node metastatic scope. Univariate and multivariate analyses of preoperative examination results were performed to identify the predictors of metastatic scope. ROC curves were constructed, and the area under the curve (AUC) was calculated to estimate diagnostic values. Results. Serum CEA (OR: 3.73; 95% CI: 1.84–7.56; P≤0.001), tumor size (OR: 2.07; 95% CI: 1.08–3.98; P=0.03), and CT examination results (OR: 17.81; 95% CI: 9.18–34.55; P≤0.001) were identified as independent predictors. The AUC proved that they possessed significant diagnostic value. When CT examination was negative, the combination of serum CEA and tumor size showed high specificity (95.3%; 164/172), negative predictive value (92.7%; 164/177), and accuracy (89.0%; 170/191). Conclusions. Preoperative serum CEA, tumor size, and CT examination are independent predictors of lymph node metastatic scope and can be used for selecting the appropriate lymphadenectomy pattern in gastric cancer patients.http://dx.doi.org/10.1155/2018/4914201
spellingShingle Jia-Le Zhang
Zhen-Ning Wang
Hui-Mian Xu
Zhi Zhu
Bao-Jun Huang
Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?
Gastroenterology Research and Practice
title Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?
title_full Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?
title_fullStr Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?
title_full_unstemmed Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?
title_short Can Preoperative Examination Help Choose the Best Surgical Procedure in Gastric Cancer?
title_sort can preoperative examination help choose the best surgical procedure in gastric cancer
url http://dx.doi.org/10.1155/2018/4914201
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