The Correlation Between Computed Tomography Volumetry and Prognosis of Advanced Gastric Cancer Treated with Neoadjuvant Chemotherapy
Authors Chen C, Dong H, Shou C, Shi X, Zhang Q, Liu X, Zhu K, Zhong B, Yu J
Received 19 September 2019
Accepted for publication 7 January 2020
Published 3 February 2020 Volume 2020:12 Pages 759—768
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Chien-Feng Li
Chao Chen,1 Hao Dong,1 Chunhui Shou,1 Xiaoxiao Shi,1 Qing Zhang,1 Xiaosun Liu,1 Kankai Zhu,1 Baishu Zhong,2 Jiren Yu1
1Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Department of Radiology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China
Correspondence: Jiren Yu
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, Zhejiang Province, People’s Republic of China
Tel + 86 571 8723 6147
Fax + 86 571 8707 2577
Purpose: To investigate the feasibility and utility of computer tomography (CT) volumetry in evaluating the tumor response to neoadjuvant chemotherapy (NAC) in advanced gastric cancer (AGC) patients.
Patients and Methods: One hundred and seventeen Patients with AGC who received NAC followed by R0 resection between January 2006 and December 2012 were included. Tumor volumes were quantified using OsiriX software. The volume reduction rate (VRR) was calculated as follows: VRR = [(pre-chemotherapy total volume) − (post-chemotherapy total volume)]/(pre-chemotherapy total volume) × 100%. The optimal cut-off VRR for differentiating favorable from unfavorable prognosis was determined by receiver operating characteristic (ROC) analysis. Overall survival was calculated using Kaplan-Meier analysis and values were compared using the Log-rank test. Multivariate analysis was determined by the Cox proportional regression model.
Results: The optimal cut-off VRR was 31.95% according to ROC analysis, with a sensitivity of 70.4% and a specificity of 71.7%. Based on the cut-off VRR, patients were divided into the VRR-High (VRR ≥ 31.95%, n = 63) and VRR-Low (VRR < 31.95%, n = 54) groups. The VRR-Low group exhibited a worse prognosis than that of the VRR-High group (HR, 2.85; 95% CI, 1.69– 4.82, P < 0.001), with 3-year survival rates of 40.7% and 79.4%, and 5-year survival rates of 31.5% and 63.5%, respectively.
Conclusion: CT volumetry is a feasible and reliable method for assessing the tumor response to NAC in patients with AGC.
Keywords: advanced gastric cancer, neoadjuvant chemotherapy, computed tomography volumetry
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