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Routine chest CT for staging of gastric cancer
A-H Chen1, W-H Chan1, Y-H Lee1
1Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Taoyuan, Taiwan.
The British Journal of Surgery
|June 19, 2019
Summary
Routine chest CT scans are not recommended for gastric cancer staging. This study found pulmonary metastases were rare and never isolated, questioning the clinical value of routine chest CT for detecting lung spread.
Area of Science:
- Oncology
- Medical Imaging
Background:
- International guidelines suggest chest CT for detecting pulmonary metastases in gastric cancer staging.
- This study evaluates the clinical utility of routine chest CT for gastric cancer staging.
Purpose of the Study:
- To assess the value of routine chest CT in staging gastric cancer patients.
- To determine the incidence and pattern of pulmonary metastases in gastric cancer.
Main Methods:
- Retrospective analysis of 1669 gastric cancer patients staged between 2008-2014.
- Evaluation of metastasis patterns, sites, and numbers at presentation and post-surgery.
- Pulmonary metastases defined as multiple small round nodules; chest X-ray also considered.
Main Results:
- 28.6% of patients had metastatic disease at presentation; peritoneum and liver were most common sites.
- Pulmonary metastases occurred in only 5.6% at presentation and 7.6% post-surgery, never as isolated sites.
- Lung metastases were often detected by chest X-ray, and prevalence was low (1.6% at presentation, 1.5% post-surgery).
Conclusions:
- Routine chest CT is not supported for gastric cancer staging.
- Isolated pulmonary metastases were not detected, limiting the added value of chest CT in this context.
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