PRE-OPERATIVE EVALUATION AND TUMOUR-NODE-METASTASIS STAGING OF GASTRIC CARCINOMA USING 16 SLICE MULTIDETECTOR-ROW COMPUTED TOMOGRAPHY

Abstract

OBJECTIVE: To evaluate pre-operative tumour-node-metastasis staging (TNM) staging, metastases status and detection of role of multidetector-row computed tomography (MDCT) in gastric carcinoma patients in Pakistan. METHODS: This cross-sectional study, spanned over 14 months (January 2018-February 2019), was conducted at Radiology Department of Kuwait Teaching Hospital. Sample size was 173. Patients, selected through non-probability consecutive sampling technique, irrespective of gender, aged over 18 years and having clinically and histopathologically diagnosed with gastric carcinoma were included in the study. MDCT of patients was done. SPSS Version-24 was utilized for data analysis. Chi-square test was applied with p-value ≤0.05 was considered significant. RESULTS: Out of total 173 patients with gastric carcinoma, 121 (69.9%) were males and 52 (30.1%) were females. Mean age of patients was 48.5±1.2 years. Majority of patients were in T4a stage (n=64; 37%) followed T4b, T3, T0, T1 & T2 (24.9%, 17.3%, 11% and 9.8%) respectively.  N0 stage with no nodal metastases was 40.5% followed by N1 stage (1-2 lymph nodes), N2 stage (3-6 lymph nodes), N3a stage (7-15 lymph nodes) and N3b stage (more than 15 lymph nodes) with 25.4%, 19.7%, 5.8% and 8.7% respectively. M1 stage with distant metastases was in 76 (43.9%) patients. Age and gender had insignificant association with TNM system (p>0.05). CONCLUSION: Multi detector row computed tomography was effective in pre-operative evaluation and TNM staging of gastric carcinoma. Lymph node detection on MDCT can further be utilized for fine needle biopsies if required.