Cargando…
The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis
Background: Peritoneal metastasis (PM) is the most common cause of death in gastric cancer (GC) patients. However, diagnosis of PM is still difficult in clinical practice. This study aimed to explore the diagnostic and prognostic value of digital rectal examination (DRE) in GC. Methods: 247 GC patie...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Ivyspring International Publisher
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485225/ https://www.ncbi.nlm.nih.gov/pubmed/31031858 http://dx.doi.org/10.7150/jca.29814 |
_version_ | 1783414244110237696 |
---|---|
author | Guo, Jing Chen, Yongming Liu, Zhimin Guan, Yuanxiang Wang, Wei Sun, Xiaowei Li, Wei Xu, Dazhi |
author_facet | Guo, Jing Chen, Yongming Liu, Zhimin Guan, Yuanxiang Wang, Wei Sun, Xiaowei Li, Wei Xu, Dazhi |
author_sort | Guo, Jing |
collection | PubMed |
description | Background: Peritoneal metastasis (PM) is the most common cause of death in gastric cancer (GC) patients. However, diagnosis of PM is still difficult in clinical practice. This study aimed to explore the diagnostic and prognostic value of digital rectal examination (DRE) in GC. Methods: 247 GC patients with PM confirmed by operation were included. The diagnostic yield of DRE compared with computed tomography (CT) was calculated. In another group of 1330 cases receiving radical gastrectomy, 38 cases with DRE (+) postoperatively were analyzed to identify risk factors. A nomogram was constructed to predict postoperative DRE (+). Results: The specificity, positive predictive value and positive likelihood ratio of DRE in diagnosis of PM was 99.8%, 91.2% and 58.4, higher than CT (97.6%, 64.9% and 10.4). Though the sensitivity of DRE (12.6%) was lower than CT (24.7%), 17 of 31 patients with DRE (+) could not be found by CT. Moreover, the overall survival of confirmed PM patients with DRE (+) (PM-DRE (+)) was much lower than PM-DRE (-) patients (P<0.001). In addition, the nomogram to predict postoperative DRE (+) had a bootstrap-corrected concordance index of 0.73 and was well calibrated. Conclusions: GC patients with DRE (+) could be regarded as a special subtype of stage IV ones with poorer prognosis. Supply of palliative care and chemotherapy rather than unnecessary operation might be a better alternative for these patients. DRE was an effective supplement for CT and should be generally recommended for GC patients. |
format | Online Article Text |
id | pubmed-6485225 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Ivyspring International Publisher |
record_format | MEDLINE/PubMed |
spelling | pubmed-64852252019-04-26 The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis Guo, Jing Chen, Yongming Liu, Zhimin Guan, Yuanxiang Wang, Wei Sun, Xiaowei Li, Wei Xu, Dazhi J Cancer Research Paper Background: Peritoneal metastasis (PM) is the most common cause of death in gastric cancer (GC) patients. However, diagnosis of PM is still difficult in clinical practice. This study aimed to explore the diagnostic and prognostic value of digital rectal examination (DRE) in GC. Methods: 247 GC patients with PM confirmed by operation were included. The diagnostic yield of DRE compared with computed tomography (CT) was calculated. In another group of 1330 cases receiving radical gastrectomy, 38 cases with DRE (+) postoperatively were analyzed to identify risk factors. A nomogram was constructed to predict postoperative DRE (+). Results: The specificity, positive predictive value and positive likelihood ratio of DRE in diagnosis of PM was 99.8%, 91.2% and 58.4, higher than CT (97.6%, 64.9% and 10.4). Though the sensitivity of DRE (12.6%) was lower than CT (24.7%), 17 of 31 patients with DRE (+) could not be found by CT. Moreover, the overall survival of confirmed PM patients with DRE (+) (PM-DRE (+)) was much lower than PM-DRE (-) patients (P<0.001). In addition, the nomogram to predict postoperative DRE (+) had a bootstrap-corrected concordance index of 0.73 and was well calibrated. Conclusions: GC patients with DRE (+) could be regarded as a special subtype of stage IV ones with poorer prognosis. Supply of palliative care and chemotherapy rather than unnecessary operation might be a better alternative for these patients. DRE was an effective supplement for CT and should be generally recommended for GC patients. Ivyspring International Publisher 2019-02-23 /pmc/articles/PMC6485225/ /pubmed/31031858 http://dx.doi.org/10.7150/jca.29814 Text en © Ivyspring International Publisher This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions. |
spellingShingle | Research Paper Guo, Jing Chen, Yongming Liu, Zhimin Guan, Yuanxiang Wang, Wei Sun, Xiaowei Li, Wei Xu, Dazhi The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis |
title | The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis |
title_full | The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis |
title_fullStr | The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis |
title_full_unstemmed | The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis |
title_short | The Diagnostic and Prognostic Value of Digital Rectal Examination in Gastric Cancer Patients with Peritoneal Metastasis |
title_sort | diagnostic and prognostic value of digital rectal examination in gastric cancer patients with peritoneal metastasis |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6485225/ https://www.ncbi.nlm.nih.gov/pubmed/31031858 http://dx.doi.org/10.7150/jca.29814 |
work_keys_str_mv | AT guojing thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT chenyongming thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT liuzhimin thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT guanyuanxiang thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT wangwei thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT sunxiaowei thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT liwei thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT xudazhi thediagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT guojing diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT chenyongming diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT liuzhimin diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT guanyuanxiang diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT wangwei diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT sunxiaowei diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT liwei diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis AT xudazhi diagnosticandprognosticvalueofdigitalrectalexaminationingastriccancerpatientswithperitonealmetastasis |