Gastric cancer with synchronous and metachronous hepatic metastasis predicted by enhancement pattern on multiphasic contrast-enhanced CT

Tsurumaru, Daisuke; Nishimuta, Yusuke; Muraki, Takamura; Asayama, Yoshiki; Nishie, Akihiro; Oki, Eiji; Honda, Hiroshi

doi:10.1016/j.ejrad.2018.09.030

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…e analysis of the rehabilitation effect of the patients showed that the number of CR (5 cases), PR (13 cases), RR (18 cases), and DCR (44 cases) in the experimental group was significantly more than that in the control group, while the number of PD (12 cases) was significantly less than that in the control group (P < 0.05). It suggested that the PTX combined with decitabine sequential decitabine maintenance treatment program was better than the decitabine combined with cisplatin first-line treatment program for patients with advanced gastric cancer [25]. From the side effects of patients, the number of patients with hematological toxicity, leukopenia, thrombocytopenia, and gastrointestinal reactions after treatment in the experimental group was significantly less than that in the control group (P < 0.05), which proved that PTX combined with decitabine sequential decitabine maintenance therapy had the advantage of less toxic side effects, which advanced gastric cancer can tolerate [26].…”

Section: Discussionmentioning

confidence: 99%

Segmentation of Gastric Computerized Tomography Images under Intelligent Algorithms in Evaluation of Efficacy of Decitabine Combined with Paclitaxel in Treatment of Gastric Cancer

Wang

Li³

2021

Journal of Healthcare Engineering

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To analyze the evaluation of artificial intelligence algorithm combined with gastric computed tomography (CT) image in clinical chemotherapy for advanced gastric cancer, 112 patients with advanced gastric cancer were selected as the research object. Among which, 56 patients in the experimental group received paclitaxel (PTX) combined with decitabine sequential decitabine maintenance therapy. Fifty-six patients in the control group received first-line treatment with decitabine combined with cisplatin. The image segmentation algorithm based on fast interactive dictionary selection was used to process gastric CT images. Complete response (CR), partial response (PR), stable disease (SD), progressive disease (PD), response rate (RR), disease control rate (DCR), and overall survival (OS) after treatment were recorded. The true-positive rate (TPR) and coincidence ratio (CR) of the proposed algorithm for image segmentation were significantly higher than those of the mean shift algorithm and the iCoseg algorithm. The mean edge distance (MED) and edge distance variance (EDV) were significantly lower than the mean shift algorithm and the iCoseg algorithm, and the differences were considerable ( P < 0.05 ). The number of CR (5 cases), PR (13 cases), RR (18 cases), and DCR (44 cases) in the experimental group was significantly higher than that in the control group, while the number of PD (12 cases) was significantly lower than that in the control group ( P < 0.05 ). The number of patients complicated with hematological toxicity, leucopenia, thrombocytopenia, and digestive tract reaction in the experimental group was less than that in the control group ( P < 0.05 ). From the comparison of long-term efficacy, the survival rate of patients in both groups showed a decreasing trend within 24 months, but the decreasing trend of survival rate of patients in the experimental group was better than that in the control group. In short, the proposed algorithm had better segmentation performance than traditional algorithms. Compared with first-line treatment with decitabine and cisplatin, PTX in combination with decitabine sequential citabine maintenance regimens had better disease control rates, lower toxicity, and more effective improvements in patient quality of life and longer survival in patients with advanced gastric cancer.

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Section: Discussionmentioning

confidence: 99%

Segmentation of Gastric Computerized Tomography Images under Intelligent Algorithms in Evaluation of Efficacy of Decitabine Combined with Paclitaxel in Treatment of Gastric Cancer

Wang

Li³

2021

Journal of Healthcare Engineering

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“…CS may not be suitable for some patients who have liver metastasis before initial treatment. Tsurumaru et al reported that tiny lesions or microscopic metastases are not detectable even with the use of high‐resolution imaging 21 . Shirasu et al reported that the indications for hepatectomy for multiple liver metastases remain unclear 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Tsurumaru et al reported that tiny lesions or microscopic metastases are not detectable even with the use of high‐resolution imaging. 21 Shirasu et al reported that the indications for hepatectomy for multiple liver metastases remain unclear. 22 We also found that liver metastases were associated with VER.…”

Section: Discussionmentioning

confidence: 99%

Clinical impact of very early recurrence after conversion surgery for stage IV gastric cancer

Morito,

Eto,

Iwatsuki

et al. 2023

Annals of Gastroent Surgery

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BackgroundThe development and improved response to chemotherapy has resulted in a survival benefit of conversion surgery (CS) for advanced gastric cancer (GC). However, this benefit is limited in some cases, such as in those with very early recurrence (VER). This study investigated the relationship between outcome and clinicopathological characteristics after CS for stage IV GC, and the risk factors for VER after CS.MethodsWe retrospectively studied 184 patients with stage IV GC who initially underwent chemotherapy, including 36 patients who underwent CS between May 2007 and January 2022. We evaluated the long‐term outcome after CS for stage IV GC and the clinicopathological characteristics of the patients who underwent CS.ResultsMedian survival times (MSTs) in the chemotherapy alone and CS groups were 13.4 and 36.5 months, respectively (p < 0.0001). Of the 27 patients who underwent R0 resection, 22 remained free of early recurrence and five experienced VER. MSTs in the VER and free of early recurrence groups were 15.2 and 44.1 months, respectively (p < 0.0001). Significantly more patients had liver metastasis before initial treatment in the VER group than in the FER group (p = 0.016). There were more patients with preoperative PNI <40 in the VER group (p = 0.046).ConclusionCS is an effective treatment for stage IV GC, but VER is associated with poor prognosis. We need to carefully consider the indications for CS, especially for patients with poor nutritional status and liver metastases.

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“…Various studies have reported that tumor percent enhancement could help in evaluating the prognosis of hepatocellular carcinoma, 24 distinguishing the histological type of GC, 25 predicting synchronous and metachronous hepatic metastasis in GC, 26 and determining LNM of rectal cancer. 19 , 27 These studies revealed that enhancement features of tumors play an essential role in assessing tumor prognosis and clinical stage.…”

Section: Discussionmentioning

confidence: 99%

pT1-2 gastric cancer with lymph node metastasis predicted by tumor morphologic features on contrast-enhanced computed tomography

Wang¹,

Liu²,

Zhuang³

et al. 2023

dir

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To investigate the value of tumor morphologic features of pT1-2 gastric cancer (GC) on contrast-enhanced computed tomography (CT) in assessing lymph node metastasis (LNM) with reference to histopathological results. METHODSEighty-six patients seen from October 2017 to April 2019 with pT1-2 GC proven by histopathology were included. Tumor volume and CT densities were measured in the plain scan and the portal-venous phase (PVP), and the percent enhancement was calculated. The correlations between tumor morphologic features and the N stages were analyzed. The diagnostic capability of tumor volume and enhancement features in predicting the LN status of pT1-2 GCs was further investigated using receiver operating characteristic (ROC) analysis. RESULTSTumor volume, CT density in the PVP, and tumor percent enhancement in the PVP correlated significantly with the N stage (rho: 0.307, 0.558, and 0.586, respectively). Tumor volumes were significantly lower in the LNM− group than in the LNM+ group (14.4 mm 3 vs. 22.6 mm 3 , P = 0.004). The differences between the LNM− and LNM+ groups in the CT density in the PVP and the percent enhancement in the PVP were also statistically significant (68.00 HU vs. 87.50 HU, P < 0.001; and 103.06% vs. 179.19%, P < 0.001, respectively). The area under the ROC curves for identifying the LNM+ group was 0.69 for tumor volume and 0.88 for percent enhancement in the PVP, respectively. The percent enhancement in the PVP of 145.2% and tumor volume of 17.4 mL achieved good diagnostic performance in determining LNM+ (sensitivity: 71.4%, 82.1%; specificity: 91.4%, 58.6%; and accuracy: 84.9%, 66.3%, respectively). CONCLUSIONTumor volume and percent enhancement in the PVP of pT1-2 GC could improve the diagnostic accuracy of LNM and would be helpful in image surveillance of these patients. KEYWORDSComputed tomography, contrast enhancement, gastric cancer, lymph node metastasis, tumor volume You may cite this article as: Wang Z, Liu Q, Zhuang X, et al. pT1-2 gastric cancer with lymph node metastasis predicted by tumor morphologic features on contrast-enhanced computed tomography.

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Gastric cancer with synchronous and metachronous hepatic metastasis predicted by enhancement pattern on multiphasic contrast-enhanced CT

Cited by 11 publications

References 22 publications

Segmentation of Gastric Computerized Tomography Images under Intelligent Algorithms in Evaluation of Efficacy of Decitabine Combined with Paclitaxel in Treatment of Gastric Cancer

Segmentation of Gastric Computerized Tomography Images under Intelligent Algorithms in Evaluation of Efficacy of Decitabine Combined with Paclitaxel in Treatment of Gastric Cancer

Clinical impact of very early recurrence after conversion surgery for stage IV gastric cancer

pT1-2 gastric cancer with lymph node metastasis predicted by tumor morphologic features on contrast-enhanced computed tomography

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