CT evaluation of the resectability of gastric cancer postchemotherapy

Background: To determine the accuracy of CT in the postchemotherapy assessment of resectability of gastric cancer. Methods: Thirty patients deemed to have unresectable gastric cancer on CT were studied. This was verified at laparotomy in 10 of these patients. Following initial assessment, all received three to eight cycles of chemotherapy aiming for disease control and potential resection. Serial CT examinations, endoscopy, and biopsy were performed after the fourth, sixth, and eighth cycle of treatment. The primary tumor and lymph nodes seen on CT were compared with operative findings. Results: After completion of chemotherapy, CT findings were correct in 23 patients. Fourteen of them had operable tumors and nine were inoperable. However, the CT findings were either equivocal or incorrect in the remaining seven patients. Conclusion: Chemotherapy is now able to downstage a previously inoperable gastric cancer, and CT is an accurate method in identifying those patients who can proceed to resection. Received: 24 October 1994/Accepted after revision: 6 April 1995