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Consideration of clinicopathologic features improves patient stratification for multimodal treatment of gastric cancer

Authors
 In Cho  ;  In Gyu Kwon  ;  Ali Guner  ;  Taeil Son  ;  Hyoung-Il Kim  ;  Dae Ryong Kang  ;  Sung Hoon Noh  ;  Joon Seok Lim  ;  Woo Jin Hyung 
Citation
 Oncotarget, Vol.8(45) : 79594-79603, 2017 
Journal Title
 Oncotarget 
Issue Date
2017
Keywords
diagnostic accuracy ; gastric cancer ; multimodal treatment ; patient stratification ; preoperative staging
Abstract
Preoperative staging of gastric cancer with computed tomography alone exhibits poor diagnostic accuracy, which may lead to improper treatment decisions. We developed novel patient stratification criteria to select appropriate treatments for gastric cancer patients based on preoperative staging and clinicopathologic features. A total of 5352 consecutive patients who underwent gastrectomy for gastric cancer were evaluated. Preoperative stages were determined according to depth of invasion and nodal involvement on computed tomography. Logistic regression analysis was used to identify clinicopathological factors associated with the likelihood of proper patient stratification. The diagnostic accuracies of computed tomography scans for depth of invasion and nodal involvement were 67.1% and 74.1%, respectively. Among clinicopathologic factors, differentiated tumor histology, tumors smaller than 5 cm, and gross appearance of early gastric cancer on endoscopy were shown to be related to a more advanced stage of disease on preoperative computed tomography imaging than actual pathological stage. Additional consideration of undifferentiated histology, tumors larger than 5 cm, and grossly advanced gastric cancer on endoscopy increased the probability of selecting appropriate treatment from 75.5% to 94.4%. The addition of histology, tumor size, and endoscopic findings to preoperative staging improves patient stratification for more appropriate treatment of gastric cancer.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/161281
DOI
10.18632/oncotarget.18607
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김형일(Kim, Hyoung Il)
노성훈(Noh, Sung Hoon)
손태일(Son, Tae Il)
임준석(Lim, Joon Seok)
형우진(Hyung, Woo Jin)
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