Computed tomography pneumogastrography in determining clinical t-stage and yt-stage of gastric cancer

Abstract

Оbjective. To assess the sensitivity of CT pneumogastrography in determining the T-stage and yT-stage. Materials and methods. This is a prospective, single-center study that included 267 patients with a histologically diagnosed stomach cancer who received treatment at the N.N. Petrov National Medical Research Center of Oncology from 2015 to 2018. 162 (60.7%) patients underwent preoperative chemotherapy. All patients underwent surgery: 22 in the volume of proximal subtotal gastrectomy, 95 in the volume of distal subtotal resection, 123 in the volume of gastrectomy, and 27 in the volume of endoscopic dissection. All patients underwent staging computed tomography at the preoperative stage according to a single protocol - CT pneumogastrography on a 64-slice X-ray computed tomography. The sensitivity of the method in assessing the depth of invasion was calculated separately for patients without preoperative chemotherapy (T-stage) and for patients who underwent preoperative chemotherapy (уT-stage) by comparison with pathological data. Results. The sensitivity indicators of CT pneumogastrography for patients without preoperative chemotherapy were: for T1a – 80.6%, T1b – 72.7%, T2 – 80.0%, T3 – 88.0%, T4a – 83.3%, T4b –100%. The sensitivity indicators of CT pneumogastrography for patients receiving preoperative chemotherapy were: for уT2 – 65.2%, уT3 – 83.5%, уT4a – 83.9%, уT4b – 75.0%. It is difficult to restore locally advanced gastric cancer with a depth of invasion cT2 – cT4b in the category yT0, yT1a, and yT1b after preoperative chemotherapy due to the persisting pathological tissue with impaired differentiation of all layers of the stomach wall, which is pathomorphologically a large fibrous tissue. Сonclusion. CT-pneumogastrography demonstrates high diagnostic indicators in determining the T-stage and yT-stage of gastric cancer.