The impact of histological type on the accuracy of preoperative N staging in patients with gastric cancer | World Journal of Surgical Oncology | Full Text

The impact of histological type on the accuracy of preoperative N staging in patients with gastric cancer | World Journal of Surgical Oncology | Full Text

World Journal of Surgical Oncology

The impact of histological type on the accuracy of preoperative N staging in patients with gastric cancer

• Atsushi Yamamoto, 
• Yoshihiko Kawaguchi, 
• Kensuke Shiraishi, 
• Hidenori Akaike, 
• Hiroki Shimizu, 
• Shinji Furuya, 
• Naohiro Hosomura, 
• Hidetake Amemiya, 
• Hiromichi Kawaida, 
• Makoto Sudo, 
• Hiroshi Kono & 
• Daisuke Ichikawa 

World Journal of Surgical Oncologyvolume 17, Article number: 130 (2019) | Download Citation

Abstract

Background

The low accuracy of preoperative diagnosis of lymph node metastasis in gastric cancer (GC) complicates decisions on patient indication for neoadjuvant chemotherapy.

Methods

We investigated the use of preoperative clinical diagnosis of lymph node involvement (cN) in GC patients compared with postoperative pathological diagnosis.

Results

In a series of 265 patients enrolled at the University of Yamanashi Hospital, the overall sensitivity was 44.4% and specificity was 93.4% of CT for detecting lymph node metastasis. The positive and negative predictive values were 80.0% and 73.8%, respectively. The negative predictive value was lower for undifferentiated adenocarcinoma than that for differentiated adenocarcinoma (64.9% vs. 78.7%, p = 0.034). In cT2 ≤ and cN2 ≤ GC, overdiagnosis of lymph node metastasis was significantly more frequent in patients with differentiated (50.0%) than in undifferentiated (13.3%) adenocarcinoma (p = 0.046).

Conclusions

Diagnostic accuracy of lymph node involvement depended on histological type and cT-stage. Thus, considering preoperative histological type in GC, it may be useful to decide treatment plan.