PDF(Pubmed)
Abstract：
UNASSIGNED: To develop and validate a quantitative model based on gross tumor volume (GTV) of gastric adenocarcinoma (GA) corresponding to N-stage measured at multidetector computed tomography (CT) for preoperative determination of resectability.
UNASSIGNED: 493 consecutive patients with confirmed GA undergoing contrast-enhanced CT two weeks before treatments were randomly enrolled into the training cohort (TC, n = 271), internal validation cohort (IVC, n = 107) and external validation cohort (EVC, n = 115). GTV was measured on CT by multiplying sums of all tumor areas by section thickness. In TC, univariate and multivariate analyses were performed to select factors associated with resectability. Receiver operating characteristic (ROC) analysis was to determine if N-stage based GTV could identify resectability. In IVC and EVC, unweighted Cohen\'s Kappa tests were to evaluate performances of the ROC models.
UNASSIGNED: According to univariate analysis, age, cT stage, cN stage and GTV were related to resectability in TC (all P-values < 0.05), and multivariate analysis suggested that cN stage and GTV were independent risk factors with odds ratios of 1.594 (95% confidence interval [CI]: 1.105-2.301) and 1.055 (95%CI: 1.035-1.076), respectively. ROC analysis in TC revealed the cutoffs of 21.81, 21.70 and 36.93 cm3 to differentiate between resectable and unresectable cancers in stages cN0-3, cN2 and cN3 with areas under the curves of more than 0.8, respectively, which was validated in IVC and EVC with average Cohen k-values of more than 0.72.
UNASSIGNED: GTV and cN stage can be independent risk factors of unresectable GA, and N-stage based GTV can help determine resectability.
UNASSIGNED: 493 consecutive patients with confirmed GA undergoing contrast-enhanced CT two weeks before treatments were randomly enrolled into the training cohort (TC, n = 271), internal validation cohort (IVC, n = 107) and external validation cohort (EVC, n = 115). GTV was measured on CT by multiplying sums of all tumor areas by section thickness. In TC, univariate and multivariate analyses were performed to select factors associated with resectability. Receiver operating characteristic (ROC) analysis was to determine if N-stage based GTV could identify resectability. In IVC and EVC, unweighted Cohen\'s Kappa tests were to evaluate performances of the ROC models.
UNASSIGNED: According to univariate analysis, age, cT stage, cN stage and GTV were related to resectability in TC (all P-values < 0.05), and multivariate analysis suggested that cN stage and GTV were independent risk factors with odds ratios of 1.594 (95% confidence interval [CI]: 1.105-2.301) and 1.055 (95%CI: 1.035-1.076), respectively. ROC analysis in TC revealed the cutoffs of 21.81, 21.70 and 36.93 cm3 to differentiate between resectable and unresectable cancers in stages cN0-3, cN2 and cN3 with areas under the curves of more than 0.8, respectively, which was validated in IVC and EVC with average Cohen k-values of more than 0.72.
UNASSIGNED: GTV and cN stage can be independent risk factors of unresectable GA, and N-stage based GTV can help determine resectability.
摘要：
UNASSIGNED：开发和验证基于胃腺癌（GA）的大体肿瘤体积（GTV）对应于多探测器计算机断层扫描（CT）测量的N期的定量模型，用于术前确定可切除性。
UNASSIGNED：在治疗前两周接受对比增强CT的493例确诊为GA的连续患者随机纳入训练队列（TC，n=271),内部验证队列(IVC，n=107)和外部验证队列(EVC，n=115)。通过将所有肿瘤面积的总和乘以切片厚度在CT上测量GTV。在TC,进行了单因素和多因素分析,以选择与可切除性相关的因素.接收器工作特性（ROC）分析是为了确定基于N级的GTV是否可以识别可切除性。在IVC和EVC中，未加权科恩的Kappa检验是为了评估ROC模型的性能。
未经评估：根据单变量分析，年龄,cT阶段,cN分期和GTV与TC可切除性相关(P值均<0.05),多变量分析表明，cN分期和GTV是独立的危险因素，比值比为1.594（95％置信区间[CI]：1.105-2.301）和1.055（95CI：1.035-1.076）。分别。TC的ROC分析显示，截止值分别为21.81、21.70和36.93cm3，以区分cN0-3，cN2和cN3阶段的可切除和不可切除的癌症，曲线下面积分别大于0.8，这在IVC和EVC中得到了验证，平均Cohenk值超过0.72。
UNASSIGNED：GTV和cN分期可能是无法切除的GA的独立危险因素，基于N级的GTV可以帮助确定可切除性。
UNASSIGNED：在治疗前两周接受对比增强CT的493例确诊为GA的连续患者随机纳入训练队列（TC，n=271),内部验证队列(IVC，n=107)和外部验证队列(EVC，n=115)。通过将所有肿瘤面积的总和乘以切片厚度在CT上测量GTV。在TC,进行了单因素和多因素分析,以选择与可切除性相关的因素.接收器工作特性（ROC）分析是为了确定基于N级的GTV是否可以识别可切除性。在IVC和EVC中，未加权科恩的Kappa检验是为了评估ROC模型的性能。
未经评估：根据单变量分析，年龄,cT阶段,cN分期和GTV与TC可切除性相关(P值均<0.05),多变量分析表明，cN分期和GTV是独立的危险因素，比值比为1.594（95％置信区间[CI]：1.105-2.301）和1.055（95CI：1.035-1.076）。分别。TC的ROC分析显示，截止值分别为21.81、21.70和36.93cm3，以区分cN0-3，cN2和cN3阶段的可切除和不可切除的癌症，曲线下面积分别大于0.8，这在IVC和EVC中得到了验证，平均Cohenk值超过0.72。
UNASSIGNED：GTV和cN分期可能是无法切除的GA的独立危险因素，基于N级的GTV可以帮助确定可切除性。
