Evaluation of gastric adenocarcinoma. Abdominal computed tomography does not replace celiotomy

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.