The Preoperative Enhanced Degree of Contrast-enhanced CT Images: A Potential Independent Predictor in Gastric Adenocarcinoma Patients After Radical Gastrectomy

Figures & data

Figure 1 NC-CT and CE-CT scans of GACs with different DP-cCAV. CT images in the noncontrast phase (A), arterial phase (B), portal venous phase (C) and delayed phase (D) showed a thickened gastric wall in a patient of DP-cCAV^high group. CT images in the noncontrast phase (E), arterial phase (F), portal venous phase (G) and delayed phase (H) showed a thickened gastric wall in a patient of the DP-cCAV^low group.

Table 1 Baseline Characteristics of Patients with GAC According to CT Value Stratification

Variables	Total (n=435)	DP-cCAV^low(n=312)	DP-cCAV^high(n=123)	p-value
Sex
Male	334 (76.8)	250 (80.1)	84 (68.3)	0.011
Female	101 (23.2)	62 (19.9)	39 (31.7)
Age at diagnosis (years)
Median (range)	65 (29–87)	66 (29–86)	65 (31–87)	0.713
Location
Cardia and fundus	82 (18.9)	61 (19.6)	21 (17.1)	0.392
Body	111 (25.5)	78 (25.0)	33 (26.8)
Antrum and pylorus	227 (52.2)	165 (52.9)	62 (50.4)
Whole stomach	15 (3.4)	8 (2.6)	7 (5.7)
Maximum diameter of tumor(cm)	4.0 (0.5–14.0)	4.0 (0.5–14.0)	5.0 (0.5–12.5)	0.001
Differentiation degree
Differentiated type	94 (21.6)	75 (24.0)	19 (15.4)	0.003
Mixed type	104 (23.9)	83 (26.6)	21 (17.1)
Undifferentiated type	237 (54.5)	154 (49.4)	83 (67.5)
Vascular invasion status
Yes/no	155/280	100/212	55/68	0.015
Neural invasion status
Yes/no	141/294	85/227	56/67	<0.001
Pathological T stage
T1	54 (12.4)	51 (16.3)	3 (2.4)	<0.001
T2	63 (14.5)	50 (16.0)	13 (10.6)
T3	297 (68.3)	199 (63.8)	98 (79.7)
T4	21 (4.8)	12 (3.8)	9 (7.3)
Pathological N stage
N0	138 (31.7)	117 (37.5)	21 (17.1)	<0.001
N1	82 (18.9)	63 (20.2)	19 (15.4)
N2	109 (25.1)	73 (23.4)	36 (29.3)
N3	106 (24.4)	59 (18.9)	47 (38.2)
Pathological M stage
M0	418 (96.1)	302 (96.8)	116 (94.3)	0.271
M1	17 (3.9)	10 (3.2)	7 (5.7)
TNM stage
I	104 (23.9)	88 (28.2)	16 (13.0)	<0.001
II	131 (30.1)	104 (33.3)	27 (22)
III	184 (42.3)	111 (35.6)	73 (59.3)
IV	16 (3.7)	9 (2.9)	7 (5.7)
Chemotherapy after surgery
Yes/no	311/124	220/92	91/32	0.556

Abbreviation: cCAV, corrected CT attenuate value.

Table 2 Univariable and Multivariable Cox Proportional Hazards Regression Analyses of Clinical and Radiographic Features for Overall Survival in Patients with Gastric Adenocarcinoma

Variable	Univariate Analysis		Multivariate Analysis
	Crude HR (95%CI)	p-value	Adjust HR (95% CI)	p-value
Gender (male vs female)	1.126 (0.787–1.612)	0.515
Age (≥65 vs <65 years)	1.709 (1.266–2.307)	<0.001	1.805 (1.319–2.469)	<0.001
Location
Cardia and fundus	0.540 (0.260–1.122)	0.099	1.030 (0.469–2.266)	0.941
Body	0.523 (0.256–1.069)	0.076	1.053 (0.493–2.248)	0.893
Antrum and pylorus	0.458 (0.230–0.910)	0.026	0.880 (0.423–1.833)	0.733
Whole stomach	1.0
Maximum diameter of tumor (cm)	1.156 (1.098–1.218)	<0.001	1.082 (1.018–1.150)	0.012
Differentiation degree
Differentiated type	0.645 (0.425–0.981)	0.040	0.886 (0.573–1.370)	0.587
Mixed type	1.153 (0.824–1.615)	0.406	1.164 (0.824–1.645)	0.388
Undifferentiated type	1.0
TNM stage
I	0.036 (0.017–0.077)	<0.001	0.048 (0.021–0.110)	<0.001
II	0.113 (0.062–0.205)	<0.001	0.120 (0.063–0.229)	<0.001
III	0.246 (0.142–0.427)	<0.001	0.222 (0.124–0.398)	<0.001
IV	1.0
Vascular invasion status (yes vs no)	1.952 (1.454–2.62)	<0.001	1.323 (0.956–1.832)	0.091
Neural invasion status (yes vs no)	1.550 (1.146–2.096)	0.004	0.957 (0.681–1.345)	0.799
Chemotherapy after surgery (yes vs no)	0.815 (0.594–1.119)	0.207
DP-cCAV (high vs low)	2.120 (1.569–2.866)	<0.001	1.623 (1.181–2.230)	<0.001

Abbreviations: CAV, CT attenuate value; DP-cCAV, corrected CT attenuate value in the delayed phase.

Table 3 Univariate and Multivariate Analysis of Clinical and Radiographic Features for Overall Survival in Patients with Gastric Adenocarcinoma

Variable	Univariate Analysis		Multivariate Analysis
	Crude HR (95%CI)	p-value	Adjust HR (95%CI)	p-value
Gender (male vs female)	1.126 (0.787–1.612)	0.515
Age (≥65 vs <65 years)	1.709 (1.266–2.307)	<0.001*	1.805 (1.319–2.46)	<0.001*
Location
Cardia and fundus	0.540 (0.260–1.122)	0.099	1.030 (0.469–2.26)	0.941
Body	0.523 (0.256–1.069)	0.076	1.053 (0.493–2.24)	0.893
Antrum and pylorus	0.458 (0.230–0.910)	0.026*	0.880 (0.423–1.83)	0.733
Whole stomach	1.0
D-max of tumor (cm)	1.156 (1.098–1.218)	<0.001*	1.082 (1.018–1.15)	0.012*
Differentiation degree
Differentiated type	0.645 (0.425–0.981)	0.040*	0.886 (0.573–1.37)	0.587
Mixed type	1.153 (0.824–1.615)	0.406	1.164 (0.824–1.64)	0.388
Undifferentiated type	1.0
TNM stage
I	0.036 (0.017–0.077)	<0.001*	0.048 (0.021–0.11)	<0.001*
II	0.113 (0.062–0.205)	<0.001*	0.120 (0.063–0.22)	<0.001*
III	0.246 (0.142–0.427)	<0.001*	0.222 (0.124–0.39)	<0.001*
IV	1.0
Vascular invasion status (yes vs no)	1.952 (1.454–2.62)	<0.001*	1.323 (0.956–1.83)	0.091
Neural invasion status (yes vs no)	1.550 (1.146–2.096)	0.004*	0.957 (0.681–1.34)	0.799
Postoperative chemotherapy (yes vs no)	0.815 (0.594–1.119)	0.207
DP-cCAV (high vs low)	2.120 (1.569–2.866)	<0.001*	1.623 (1.181–2.230)	<0.001*

Note: *p<0.05 statistically significant.

Abbreviations: D-max, maximum diameter; DP-cCAV, corrected CAV in the delayed phase.

Figure 2 Overall survival for GAC patients according to CT value stratification.

Figure 3 Subgroup analysis for GAC patients.

Abbreviation: NR, not reached.

Figure 4 Subgroup analysis for GAC patients based on TNM stage. Figures display overall survival for patients with TNM stage I, II, III, IV GAC.