Gastric Cancer
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 14, 2005; 11(42): 6587-6592
Published online Nov 14, 2005. doi: 10.3748/wjg.v11.i42.6587
Clinical significance of CT-defined minimal ascites in patients with gastric cancer
Dong Kyung Chang, Ji Won Kim, Byung Kwan Kim, Kook Lae Lee, Chi Sung Song, Joon Koo Han, In Sung Song
Dong Kyung Chang, Ji Won Kim, Byung Kwan Kim, Kook Lae Lee, Chi Sung Song, In Sung Song, Department of Internal Medicine, Seoul National University, College of Medicine, Seoul National University Hospital, and Seoul Municipal Boramae Hospital, Seoul, Korea
Joon Koo Han, Department of Radiology, Seoul National University, College of Medicine, Seoul National University Hospital, and Seoul Municipal Boramae Hospital, Seoul, Korea
Author contributions: All authors contributed equally to the work.
Correspondence to: Ji Won Kim, MD, Department of Internal Medicine, Seoul Municipal Boramae Hospital, 395, Shindaebang 2-Dong, Dongjak-Gu, Seoul, Korea. giwkim@hanmail.net
Telephone: +82-2-840-2414 Fax:+82-2-831-0714
Received: March 17, 2005
Revised: May 9, 2005
Accepted: May 12, 2005
Published online: November 14, 2005
Abstract

AIM: To study the clinical significance of minimal ascites, which was only defined by the CT and whose nature was not determined preoperatively, in the relationship with the peritoneal carcinomatosis.

METHODS: The medical records and the dynamic CT films of 118 patients with gastric cancer were reviewed. Factors associated with peritoneal carcinomatosis were analyzed in 40 patients who had CT-defined ascites of which the nature was surgically confirmed.

RESULTS: Only 12.5-25% of the CT-defined minimal ascites, whose volume was estimated to be less than 50 mL, were associated with peritoneal carcinomatosis. When the estimated CT-defined ascitic volume was 50 mL or more, peritoneal carcinomatosis was identified in 75–100%. When CT-defined lymph node enlargements were not found beyond the regional gastric area, perigastric invasions were not suspected, and the size of tumor was less than 3 cm, peritoneal carcinomatosis seemed significantly less accompanied at the univariate analysis. However, except for the minimal volume of CT-defined ascites in comparison with the mild or more, other factors were not confirmed multivariately.

CONCLUSION: In the patients with gastric cancer, CT-defined minimal ascites alone is rarely associated with peritoneal carcinomatosis, if it does not accompany other signs suggestive of malignant seeding. Therefore, consideration of active curative resection should not be hesitated, if CT-defined minimal ascites is the only delusive sign.

Keywords: Ascites; Peritoneal carcinomatosis; Gastric cancer