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Evaluation of Gastric Adenocarcinoma: Abdominal Computed Tomography Does Not Replace Celiotomy

Evaluation of Gastric Adenocarcinoma: Abdominal Computed Tomography Does Not Replace Celiotomy Abstract • Computed tomography (CT) has been suggested as an alternative to celiotomy for predicting the stage and resectability of gastric carcinoma. Since it is the policy at our institution to explore all patients regardless of CT findings, this experience was reviewed to see if changes were warranted. Thirty-seven patients with gastric adenocarcinoma underwent preoperative CT scanning. The extent of disease found after operation was compared with the CT assessment. Nineteen patients (51%) were found to have more extensive disease than was predicted by CT. Of the six patients predicted to have widespread disease by CT, three (50%) were found at operation to have disease confined to the stomach or regional nodes. These data support a continued role for celiotomy in managing gastric adenocarcinoma of the stomach since a significant percentage of patients whose disease is believed to be unresectable after CT have potentially curable lesions. (Arch Surg 1986;121:603-606) References 1. Lawrence WT, Lawrence W Jr: Gastric cancer: The surgeon's view-point . Semin Oncol 1980;7:400-417. 2. Douglass HO Jr, Nava HR: Gastric adenocarcinoma: Managements of the primary disease . Semin Oncol 1985;12:32-45. 3. Scott HW Jr, Adkins RB Jr, Sawyers JL: Results of an aggressive surgical approach to gastric carcinoma during a 23-year period . Surgery 1985;97:55-59. 4. Walls WJ: The evaluation of malignant gastric neoplasms by ultrasonic B-scanning . Radiology 1976;118:159-163.Crossref 5. Marsden DS, Alexander CH, Yeung PK, et al: The use of 99m Tc to detect gastric malignancy . Am J Gastroenterol 1973;59:410-415. 6. Efsen F, Fishcherman K: Angiography and gastric tumors . Acta Radiol Diagn 1974;15:193-197. 7. Li DKB, Burhenne HJ: Computed tomography of the stomach and duodenum: A review . Am J Gastroenterol 1983;78:36-41. 8. Mauro MA, Lee JKT, Heiken JP, et al: Radiologic staging of gastrointestinal neoplasms . Surg Clin North Am 1984;64:67-85. 9. Lee KR, Levine E, Moffat RE, et al: Computed tomographic staging of malignant gastric neoplasms . Radiology 1979;133:151-155.Crossref 10. Balfe DM, Koehler RE, Karstaedt N, et al: Computed tomography of gastric neoplasms . Radiology 1981;140:431-436.Crossref 11. Moss AA, Schnyder P, Marks W, et al: Gastric adenocarcinoma: A comparison of the accuracy and economics of staging by computed tomography and surgery . Gastroenterology 1981;80:45-50. 12. McFee AS, Aust JB: Gastric carcinoma and the CAT scan . Gastroenterology 1981;80:196-198. 13. Komaki S, Toyshima S: CT's capability in detecting advanced gastric cancer . Gastrointest Radiol 1983;8:307-313.Crossref 14. Dehn TCB, Reznek RH, Nockler IB: The preoperative assessment of advanced gastric cancer by computed tomography . Br J Surg 1984;71: 413-417.Crossref 15. Fraser I, Nash R, James DC: Computed tomography in gastric cancer . Br J Surg 1985;72:248-250. 16. Chevalier TL, Smith FT, Harter WK, et al: Chemotherapy and combined modality therapy for locally advanced and metastatic gastric carcinoma . Semin Oncol 1985;12:32-45. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Evaluation of Gastric Adenocarcinoma: Abdominal Computed Tomography Does Not Replace Celiotomy

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References (17)

Publisher
American Medical Association
Copyright
Copyright © 1986 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1986.01400050121016
Publisher site
See Article on Publisher Site

Abstract

Abstract • Computed tomography (CT) has been suggested as an alternative to celiotomy for predicting the stage and resectability of gastric carcinoma. Since it is the policy at our institution to explore all patients regardless of CT findings, this experience was reviewed to see if changes were warranted. Thirty-seven patients with gastric adenocarcinoma underwent preoperative CT scanning. The extent of disease found after operation was compared with the CT assessment. Nineteen patients (51%) were found to have more extensive disease than was predicted by CT. Of the six patients predicted to have widespread disease by CT, three (50%) were found at operation to have disease confined to the stomach or regional nodes. These data support a continued role for celiotomy in managing gastric adenocarcinoma of the stomach since a significant percentage of patients whose disease is believed to be unresectable after CT have potentially curable lesions. (Arch Surg 1986;121:603-606) References 1. Lawrence WT, Lawrence W Jr: Gastric cancer: The surgeon's view-point . Semin Oncol 1980;7:400-417. 2. Douglass HO Jr, Nava HR: Gastric adenocarcinoma: Managements of the primary disease . Semin Oncol 1985;12:32-45. 3. Scott HW Jr, Adkins RB Jr, Sawyers JL: Results of an aggressive surgical approach to gastric carcinoma during a 23-year period . Surgery 1985;97:55-59. 4. Walls WJ: The evaluation of malignant gastric neoplasms by ultrasonic B-scanning . Radiology 1976;118:159-163.Crossref 5. Marsden DS, Alexander CH, Yeung PK, et al: The use of 99m Tc to detect gastric malignancy . Am J Gastroenterol 1973;59:410-415. 6. Efsen F, Fishcherman K: Angiography and gastric tumors . Acta Radiol Diagn 1974;15:193-197. 7. Li DKB, Burhenne HJ: Computed tomography of the stomach and duodenum: A review . Am J Gastroenterol 1983;78:36-41. 8. Mauro MA, Lee JKT, Heiken JP, et al: Radiologic staging of gastrointestinal neoplasms . Surg Clin North Am 1984;64:67-85. 9. Lee KR, Levine E, Moffat RE, et al: Computed tomographic staging of malignant gastric neoplasms . Radiology 1979;133:151-155.Crossref 10. Balfe DM, Koehler RE, Karstaedt N, et al: Computed tomography of gastric neoplasms . Radiology 1981;140:431-436.Crossref 11. Moss AA, Schnyder P, Marks W, et al: Gastric adenocarcinoma: A comparison of the accuracy and economics of staging by computed tomography and surgery . Gastroenterology 1981;80:45-50. 12. McFee AS, Aust JB: Gastric carcinoma and the CAT scan . Gastroenterology 1981;80:196-198. 13. Komaki S, Toyshima S: CT's capability in detecting advanced gastric cancer . Gastrointest Radiol 1983;8:307-313.Crossref 14. Dehn TCB, Reznek RH, Nockler IB: The preoperative assessment of advanced gastric cancer by computed tomography . Br J Surg 1984;71: 413-417.Crossref 15. Fraser I, Nash R, James DC: Computed tomography in gastric cancer . Br J Surg 1985;72:248-250. 16. Chevalier TL, Smith FT, Harter WK, et al: Chemotherapy and combined modality therapy for locally advanced and metastatic gastric carcinoma . Semin Oncol 1985;12:32-45.

Journal

Archives of SurgeryAmerican Medical Association

Published: May 1, 1986

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