Greater Omental Milky Spot Examination for Diagnosis of Peritoneal Metastasis in Gastric Cancer Patients

Zhang, Xinming; Liu, Xin; Sun, Fengbo; Li, Shouchuan; Gao, Wei; Wang, Ye

doi:10.1089/lap.2016.0295

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Surgical resection is the major treatment for GC patient (4); however, patients in advanced gastric cancer with peritoneal metastasis, a non-curable factor, showed poor prognosis (5). Peritoneal metastasis (PM) primary occurs in T4 stage (6,7). Accurate evaluation of PM status in GC patients is essential for treatment decision and prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…Accurate evaluation of PM status in GC patients is essential for treatment decision and prognosis. It was found that some biomarkers and histopathological factors (e.g., T, N staging, Greater Omental Milky Spot, and Troponin I2) could predict PM status in GC (7,8), but they just provided low prediction or were merely available postoperatively. Preoperative assessment of PM can provide useful information for performing adjuvant treatment and avoid unnecessary surgical resection, thus contributing to pretreatment decision.…”

Section: Introductionmentioning

confidence: 99%

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Radiomics Nomogram for Prediction of Peritoneal Metastasis in Patients With Gastric Cancer

et al. 2020

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The aim of this study is to evaluate whether radiomics imaging signatures based on computed tomography (CT) could predict peritoneal metastasis (PM) in gastric cancer (GC) and to develop a nomogram for preoperative prediction of PM status. Methods: We collected CT images of pathological T4 gastric cancer in 955 consecutive patients of two cancer centers to analyze the radiomics features retrospectively and then developed and validated the prediction model built from 292 quantitative image features in the training cohort and two validation cohorts. Lasso regression model was applied for selecting feature and constructing radiomics signature. Predicting model was developed by multivariable logistic regression analysis. Radiomics nomogram was developed by the incorporation of radiomics signature and clinical T and N stage. Calibration, discrimination, and clinical usefulness were used to evaluate the performance of the nomogram. Results: In training and validation cohorts, PM status was associated with the radiomics signature significantly. It was found that the radiomics signature was an independent predictor for peritoneal metastasis in multivariable logistic analysis. For training and internal and external validation cohorts, the area under the receiver operating characteristic curves (AUCs) of radiomics signature for predicting PM were 0.751 (95%CI, 0.703-0.799), 0.802 (95%CI, 0.691-0.912), and 0.745 (95%CI, 0.683-0.806), respectively. Furthermore, for training and internal and external validation cohorts, the AUCs of radiomics nomogram for predicting PM were 0.792 (95%CI, 0.748-0.836), 0.870 (95%CI, 0.795-0.946), and 0.815 (95%CI, 0.763-0.867), respectively. Conclusions: CT-based radiomics signature could predict peritoneal metastasis, and the radiomics nomogram can make a meaningful contribution for predicting PM status in GC patient preoperatively.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radiomics Nomogram for Prediction of Peritoneal Metastasis in Patients With Gastric Cancer

et al. 2020

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“…Secondly, the pathological stage of the tumor was not included in this study. Diagnosing GC in stages T3–T4, patients are more likely to have a higher risk of PM ( 47 ). Thirdly, the deviation of the results may be caused by irregular lesions.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Radiomics Model Based on 18F-FDG PET of Primary Gastric Cancer for Predicting Peritoneal Metastasis

et al. 2021

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ObjectivesThe aim of this study was to develop a preoperative positron emission tomography (PET)-based radiomics model for predicting peritoneal metastasis (PM) of gastric cancer (GC).MethodsIn this study, a total of 355 patients (109PM+, 246PM-) who underwent preoperative fluorine-18-fludeoxyglucose (18F-FDG) PET images were retrospectively analyzed. According to a 7:3 ratio, patients were randomly divided into a training set and a validation set. Radiomics features and metabolic parameters data were extracted from PET images. The radiomics features were selected by logistic regression after using maximum relevance and minimum redundancy (mRMR) and the least shrinkage and selection operator (LASSO) method. The radiomics models were based on the rest of these features. The performance of the models was determined by their discrimination, calibration, and clinical usefulness in the training and validation sets.ResultsAfter dimensionality reduction, 12 radiomics feature parameters were obtained to construct radiomics signatures. According to the results of the multivariate logistic regression analysis, only carbohydrate antigen 125 (CA125), maximum standardized uptake value (SUVmax), and the radiomics signature showed statistically significant differences between patients (P<0.05). A radiomics model was developed based on the logistic analyses with an AUC of 0.86 in the training cohort and 0.87 in the validation cohort. The clinical prediction model based on CA125 and SUVmax was 0.76 in the training set and 0.69 in the validation set. The comprehensive model, which contained a rad-score and the clinical factor (CA125) as well as the metabolic parameter (SUVmax), showed promising performance with an AUC of 0.90 in the training cohort and 0.88 in the validation cohort, respectively. The calibration curve showed the actual rate of the nomogram-predicted probability of peritoneal metastasis. Decision curve analysis (DCA) also demonstrated the good clinical utility of the radiomics nomogram.ConclusionsThe comprehensive model based on the rad-score and other factors (SUVmax, CA125) can provide a novel tool for predicting peritoneal metastasis of gastric cancer patients preoperatively.

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Techniques of staging laparoscopy and peritoneal fluid assessment in gastric cancer: a systematic review

Rawicz‐Pruszyński

Erodotou

Pelc

et al. 2023

International Journal of Surgery

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Background: Staging laparoscopy for gastric cancer is recommended to assess the tumor’s locoregional extension and exclude peritoneal disease. As there is no consensus on optimizing the procedure’s diagnostic accuracy, we aimed to systematically review the literature on operative techniques, followed by peritoneal lavage fluid assessment in gastric cancer patients. Specifically, we sought to indicate the most common characteristics of the procedure and cytological evaluation. Methods: This study was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA). The protocol for this systematic review was registered on PROSPERO database (CRD: 42022306746). On September 2022, a search was carried out using Embase, Medline ALL, Cochrane Central Register of Controlled Trials and Web of Science Core Collection. Results: The search identified 1632 studies on staging laparoscopy and 2190 studies on peritoneal fluid assessment. Some 212 studies were included. Open Hasson was the method of choice in accessing the peritoneal cavity in 65% of the studies, followed by establishing a pneumoperitoneum at 10-12mmHg in 52% of reports. Most frequently, the patient was positioned supine (70%), while a 30° scope and three ports were used to assess the peritoneal cavity clockwise (72%, 77%, and 85%, respectively). Right and left upper abdomen quadrants were the predominant area of laparoscopic exploration (both 65%), followed by primary tumor region (54%), liver and pelvis (both 30%), small bowel and spleen (19% and 17%, respectively). Regions of peritoneal lavage and aspiration were limited to pelvis (50%), followed by right and left upper abdomen quadrants (37.5% and 50%, respectively). No studies compared different methods of operative techniques or analysis of ascites/fluid. Conclusions: This study indicates a high heterogeneity in the technique of staging laparoscopy and peritoneal fluid assessment in gastric cancer patients. Further research and initiatives to reach a consensus on the standardization of the procedure are warranted.

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Greater Omental Milky Spot Examination for Diagnosis of Peritoneal Metastasis in Gastric Cancer Patients

Abstract: The laparoscopic exploration could make a preliminary diagnosis of peritoneal metastasis via serosal layer invasion detection. For further analyses, cytological examinations of greater omental milky spots were more sensitive than exfoliative cytology.

Cited by 3 publications

References 29 publications

Radiomics Nomogram for Prediction of Peritoneal Metastasis in Patients With Gastric Cancer

Radiomics Nomogram for Prediction of Peritoneal Metastasis in Patients With Gastric Cancer

Development and Validation of a Radiomics Model Based on 18F-FDG PET of Primary Gastric Cancer for Predicting Peritoneal Metastasis

Techniques of staging laparoscopy and peritoneal fluid assessment in gastric cancer: a systematic review

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