Evidence map›Paper›PMID 21837458›Full record

SynthesisGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2012

How useful is preoperative imaging for tumor, node, metastasis (TNM) staging of gastric cancer? A meta-analysis.

Rajini Seevaratnam, Roberta Cardoso, Caitlin McGregor, Laercio Lourenco, Alyson Mahar, Rinku Sutradhar, Calvin Law, Lawrence Paszat, Natalie Coburn

Abstract readComparative StudyMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 126 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
126citing papers in PubMed, 10 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

126 citing papers in PubMed, 10 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Guideline
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  8. A systematic review of the accuracy and indications for diagnostic laparoscopy prior to curative-intent resection of gastric cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2012
    Pooled it
  9. Systematic review of pancreaticoduodenectomy for locally advanced gastric cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2012
    Pooled it
  10. A systematic review and meta-analysis of the utility of EUS for preoperative staging for gastric cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2012
    Pooled it
  11. Trial
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  13. Tackling similarities and differences in global practice guidelines for gastric cancer: a review on the latest Taiwan guidelines with Asia-Pacific, European and US guidelines.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
    Review
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  19. Asian consensus on normothermic intraperitoneal and systemic treatment for gastric cancer with peritoneal metastasis.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025
    Article
  20. Article

66 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Rajini SeevaratnamSunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Canada.
Roberta Cardoso
Caitlin McGregor
Laercio Lourenco
Alyson Mahar
Rinku Sutradhar
Calvin Law
Lawrence Paszat
Natalie Coburn

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSurgery is the fundamental curative option for gastric cancer patients. Imaging scans are routinely prescribed in an attempt to stage the disease prior to surgery. Consequently, the correlation between radiology exams and pathology is crucial for appropriate treatment planning.

methodsSystematic searches were conducted using Medline, Embase, and the Cochrane Central Register of Controlled Trials from January 1, 1998 to December 1, 2009. We calculated the accuracy, overstaging rate, understaging rate, Kappa statistic, sensitivity, and specificity for abdominal ultrasound (AUS), computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET) with respect to the gold standard (pathology). We also compared the performance of CT by detector number and image type. A meta-analysis was performed.

resultsFor pre-operative T staging MRI scans had better performance accuracy than CT and AUS; CT scanners using ≥ 4 detectors and multi-planar reformatted (MPR) images had higher staging performances than scanners with <4 detectors and axial images only. For pre-operative N staging PET had the lowest sensitivity, but the highest specificity among modalities; CT performance did not significantly differ by detector number or addition of MPR images. For pre-operative M staging performance did not significantly differ by modality, detector number, or MPR images.

conclusionsThe agreement between pre-operative TNM staging by imaging scans and post-operative staging by pathology is not perfect and may affect treatment decisions. Operator dependence and heterogeneity of data may account for the variations in staging performance. Physicians should consider this discrepancy when creating their treatment plans.

Indexed as

Decision MakingDiagnostic ImagingHumansLymphatic MetastasisNeoplasm StagingPreoperative CareSensitivity and SpecificityStomach NeoplasmsTomography, X-Ray Computed

Identifiers

PMID21837458

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.