COMPARATIVE ANALYSIS OF COMPUTER TOMOGRAPHIC STAGING AND POSTOPERATIVE PATHOMORPHOLOGICAL STAGING IN STOMACH CANCER
Introduction. Gastric cancer remains one of the leading causes of malignant mortality worldwide and occupies a significant place in the oncological morbidity structure in Kazakhstan. Accurate preoperative assessment of the extent of the disease is essential for choosing the optimal treatment strategy. Computed tomography (CT) is widely used for gastric cancer staging, but its accuracy can vary depending on the stage of the disease, the biological characteristics of the tumor, and the technical parameters of the examination.
Aim. To evaluate the concordance between the results of CT staging and the final pathological conclusion in patients with gastric cancer in the clinical practice of Kazakhstan.
Materials and methods. A retrospective analysis of CT scans was conducted in patients with histologically confirmed gastric cancer referred from various regions of the country and operated on at the National Research Oncology Center. All CT scans were performed before surgery. Staging results were compared with postoperative pathological data. Sensitivity, specificity, accuracy, and the Kappa coefficient of agreement were calculated.
Results. The study included 42 patients. The accuracy of CT based on the T-score ranged from 73.2% (T3) to 95.1% (T4a), with the highest concordance for T4a (κ=0.72). For N-stage, the accuracy was 78.6% (κ=0.46). When assessing M-stage, the overall accuracy reached 87.8%, but the kappa coefficient was negative (κ=–0.06), which is associated with the rarity of M1 detection. The rate of understaging exceeded the rate of overstaging, especially at early stages T1–T2.
Conclusion. CT demonstrates high diagnostic efficacy in assessing late T-stage disease and distant metastases, but its capabilities in early stages and in detecting lymph node metastases are limited. Optimization of protocols and integration of CT with endoscopic ultrasound and staging laparoscopy can improve staging accuracy and clinical outcomes in patients with gastric cancer.
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Sapayev M.N., Bainayeva B.S., Jakipov M.A., Kozhakhmetov A.M., Mamlin M.A., Kerimkulov A.K., Ussipbekov B.N., Bolsynbekova S.O., Manatova A.M., Burkitbaev Z.K. Comparative analysis of computer tomographic staging and postoperative pathological staging in stomach cancer // Nauka i Zdravookhranenie [Science & Healthcare]. 2025. Vol.27 (5), pp. 56-62. doi 10.34689/SH.2025.27.5.007Похожие публикации:
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