An ascites grading system for predicting the prognosis of gastric cancer with peritoneum dissemination

Aim Gastric cancer with peritoneum dissemination is intractable with surgical resection. The evaluation of the degree of dissemination using computed tomography (CT) is difficult. We focused on the amount of ascites based on CT findings and established a scaling system to predict these patients’ pro...

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Bibliographic Details
Published in:Annals of gastroenterological surgery 2020-11, Vol.4 (6), p.660-666
Main Authors: Honda, Michitaka, Kawamura, Hidetaka, Kobayashi, Hiroshi, Takiguchi, Koichi, Muto, Atsushi, Yamazaki, Shigeru, Teranishi, Yasushi, Shiraso, Satoru, Kono, Koji, Hori, Soshi, Kamiga, Takahiro, Iwao, Toshiyasu, Yamashita, Naoyuki
Format: Article
Language:English
Subjects:
Abdomen
Age
Antigens
Ascites
Biomarkers
Body mass index
Cellular biology
Chemotherapy
Comorbidity
Confounding (Statistics)
Enrollments
Gastric cancer
Gastrointestinal surgery
Laparoscopy
Liver
Medical prognosis
Metastasis
Original
peritoneal dissemination
prognosis
Surgeons
Surgery
Tomography
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Summary:Aim Gastric cancer with peritoneum dissemination is intractable with surgical resection. The evaluation of the degree of dissemination using computed tomography (CT) is difficult. We focused on the amount of ascites based on CT findings and established a scaling system to predict these patients’ prognoses. Methods We extracted individual data from a population‐based cohort. Patients diagnosed with histologically proven gastric adenocarcinoma with peritoneum dissemination were enrolled. Two raters evaluated the CT images and determined the grade of ascites in each patient: grade 0 indicated no ascites in all slices; grade 1 indicated ascites detected only in the upper or lower abdominal cavity; grade 2 indicated ascites detected in both the upper and lower abdominal cavities; and grade 3 indicated ascites extending continuously from the pelvic cavity to the upper abdominal cavity. We evaluated the relationship between the ascites grade and survival time. After adjusting for other clinical factors, we calculated hazard ratios of each ascites grade. Results A total of 718 patients were enrolled. The number of patients with grades 0, 1, 2, and 3 were 303, 223, 94, and 98, respectively. The median overall survival times were 16.0, 8.7, 5.4, and 3.0 months for ascites on CT grades 0, 1, 2, and 3, respectively (P 
ISSN:2475-0328
2475-0328
DOI:10.1002/ags3.12386