PREOPERATIVE ASSESSMENT OF ADVANCED GASTRIC-CARCINOMA USING COMPUTED-TOMOGRAPHY

Objectives: The Pole of computed tomography (CT) for the staging of ga stric carcinoma is controversial, The purpose of this study was to eva luate tile utility of CT in assessing the perigastric spread of advanc ed gastric carcinoma, Methods: The study included 56 patients who unde rwent dynamic CT and laparotomy for the treatment of node-positive gas tric adenocarcinoma, Preoperative CT findings were compared with surgi cal findings, and diagnostic accuracy was estimated. Results: Sensitiv ity, specificity, and accuracy of preoperative CT in determining the p erigastric tumor spreads were 33, 97, and 73% in pancreatic invasion, 36, 97, and 70 % in level III lymph node involvement, and 89, 98, and 96% in liver metastasis, Peritoneal dissemination was not detected in 15 of 56 patients (27%), and stage TV disease was mot diagnosed correc tly in 18 of 40 patients (45%), Conclusions: Radiologists and surgeons must remember that pancreatic invasion, er;tended lymph node metastas is, and peritoneal dissemination are sometimes overlooked in CT examin ation in patients with advanced gastric carcinoma.