{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:45:00Z","timestamp":1792201500860,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,8,16]],"date-time":"2020-08-16T00:00:00Z","timestamp":1597536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Gastric cancer with peritoneum dissemination is intractable with surgical resection. The evaluation of the degree of dissemination using computed tomography (CT) is difficult. We focused on the amount of ascites based on CT findings and established a scaling system to predict these patients\u2019 prognoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We extracted individual data from a population\u2010based cohort. Patients diagnosed with histologically proven gastric adenocarcinoma with peritoneum dissemination were enrolled. Two raters evaluated the CT images and determined the grade of ascites in each patient: grade 0 indicated no ascites in all slices; grade 1 indicated ascites detected only in the upper or lower abdominal cavity; grade 2 indicated ascites detected in both the upper and lower abdominal cavities; and grade 3 indicated ascites extending continuously from the pelvic cavity to the upper abdominal cavity. We evaluated the relationship between the ascites grade and survival time. After adjusting for other clinical factors, we calculated hazard ratios of each ascites grade.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 718 patients were enrolled. The number of patients with grades 0, 1, 2, and 3 were 303, 223, 94, and 98, respectively. The median overall survival times were 16.0, 8.7, 5.4, and 3.0\u00a0months for ascites on CT grades 0, 1, 2, and 3, respectively (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001). The adjusted hazard ratios for the survival time were 1.74 (1.33\u20102.26, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), 3.20 (2.25\u20104.57, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), and 4.76 (3.16\u20107.17, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001) for grades\u00a01, 2, and 3, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We established a new grading system of pretreatment ascites to better predict the prognosis of gastric cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ags3.12386","type":"journal-article","created":{"date-parts":[[2020,8,16]],"date-time":"2020-08-16T11:18:35Z","timestamp":1597576715000},"page":"660-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["An ascites grading system for predicting the prognosis of gastric cancer with peritoneum dissemination"],"prefix":"10.1002","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3492-9881","authenticated-orcid":false,"given":"Michitaka","family":"Honda","sequence":"first","affiliation":[{"name":"Department of Minimally Invasive Surgical and Medical Oncology Fukushima Medical University Fukushima Japan"},{"name":"Department of Surgery Southern TOHOKU General Hospital Koriyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Surgical and Medical Oncology Fukushima Medical University Fukushima Japan"},{"name":"Department of Surgery Southern TOHOKU General Hospital Koriyama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive Surgical and Medical Oncology Fukushima Medical University Fukushima 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