A Quantitative Model Based on Gross Tumor Volume of Gastric Adenocarcinoma Corresponding to N-stage Measured at Multidetector Computed Tomography for Preoperative Determination of Resectability: A Case Control Study

Overview

Journal Front Oncol

Specialty Oncology

Date 2022 Oct 24

PMID 36276081

Authors

Zi-Yi Yu

Dan Gao

Zhao Tang

Hai-Ying Zhou

Jing Ou

Ke-Ying Li

Xiao-Qian Chen

Dan Yang

Lin-Li Yan

Rui Li

Xiao-Ming Zhang

Tian-Wu Chen

Affiliations

Soon will be listed here.

Abstract

Purpose: To develop and validate a quantitative model based on gross tumor volume (GTV) of gastric adenocarcinoma (GA) corresponding to N-stage measured at multidetector computed tomography (CT) for preoperative determination of resectability.

Materials And Methods: 493 consecutive patients with confirmed GA undergoing contrast-enhanced CT two weeks before treatments were randomly enrolled into the training cohort (TC, n = 271), internal validation cohort (IVC, n = 107) and external validation cohort (EVC, n = 115). GTV was measured on CT by multiplying sums of all tumor areas by section thickness. In TC, univariate and multivariate analyses were performed to select factors associated with resectability. Receiver operating characteristic (ROC) analysis was to determine if N-stage based GTV could identify resectability. In IVC and EVC, unweighted Cohen's Kappa tests were to evaluate performances of the ROC models.

Results: According to univariate analysis, age, cT stage, cN stage and GTV were related to resectability in TC (all -values < 0.05), and multivariate analysis suggested that cN stage and GTV were independent risk factors with odds ratios of 1.594 (95% confidence interval [CI]: 1.105-2.301) and 1.055 (95%CI: 1.035-1.076), respectively. ROC analysis in TC revealed the cutoffs of 21.81, 21.70 and 36.93 cm to differentiate between resectable and unresectable cancers in stages cN, cN and cN with areas under the curves of more than 0.8, respectively, which was validated in IVC and EVC with average Cohen k-values of more than 0.72.

Conclusions: GTV and cN stage can be independent risk factors of unresectable GA, and N-stage based GTV can help determine resectability.

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