Computed Tomography-Based Diagnosis of Gastric Vein Invasion in Patients with Gastric Cancer

Abstract

Objective: The objective of this study was to demonstrate computed tomography (CT)-based diagnosis ofvenous invasion in patients with gastric cancer and its prognostic value.Materials and Methods: Medical records and CT examinations of 530 patients with gastric cancer diagnosedafter biopsy from February 2003 to December 2015 were included in this retrospective study. An imagingbaseddiagnosis of venous invasion was established when one of the following criteria were satisfied: 1)tumoral enhancement in the lumen of the vein, 2) tumor protruding through the course of a vein, and 3)distention of the vein due to extension of the gastric tumor. CT-based diagnosis of gastric vein invasion wasestablished in 11/530 patients.Results: Histopathological examination revealed poorly differentiated gastric adenocarcinoma (n=10) andneuroendocrine carcinoma (n=1). The median survival of the patients after the initial CT was 153.5 (range:6–1275) days. Tumor invasion was observed at the aberrant left gastric vein (n=2), right gastroepiploic andsuperior mesenteric vein (n=2), gastric vein (n=4), and short gastric vein (n=3). Two of the three patientswith short gastric vein invasion died 6 and 7 days after the initial CT, respectively.Conclusion: All draining veins of the stomach can be invaded by gastric cancer; CT can enable diagnosis thatmay be important for prognosis and surgical planning. The presence of short gastric vein invasion detectedby CT may be associated with poor prognosis.