{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:24:44Z","timestamp":1771327484053,"version":"3.50.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2021,1,14]],"date-time":"2021-01-14T00:00:00Z","timestamp":1610582400000},"content-version":"vor","delay-in-days":576,"URL":"http:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/"},{"start":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T00:00:00Z","timestamp":1560816000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nd\/4.0\/"},{"start":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T00:00:00Z","timestamp":1560816000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,7,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>International guidelines on clinical staging of gastric cancer recommend the use of chest CT for the detection of pulmonary metastases. This study assessed the clinical value of routine chest CT in the staging of gastric cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective study included patients identified from the gastric cancer registry of Chang Gung Memorial Hospital, Linkou, Taiwan. All patients who underwent clinical staging between 2008 and 2014 were included. The pattern, site and number of metastases at initial presentation and after surgery with curative intent were evaluated. Pulmonary metastases were defined as multiple small round pulmonary nodules with a random distribution or of variable size.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Some 1669 patients were included, of whom 478 (28\u00b76 per cent) had metastatic disease at clinical presentation. The majority of metastases were to the peritoneum (75\u00b77 per cent of patients) or liver (30\u00b75 per cent), and only 27 patients (5\u00b76 per cent) had pulmonary metastases at presentation, none of which were isolated to the lung. Of these 27 patients, 11 had primary lesions located at the cardia\/fundus. In 19 patients the lung metastases were also detected on the staging chest X-ray. After surgery there were 196 cancer recurrences. Some 15 patients (7\u00b76 per cent) had lung metastasis and this was not the only site of metastases in any patient. The prevalence of lung metastasis at presentation of the disease and after surgery was 1\u00b76 and 1\u00b75 per cent respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This study does not support the routine use of chest CT for staging of gastric cancer as isolated pulmonary metastasis in the absence of other metastatic sites could not be detected.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.11186","type":"journal-article","created":{"date-parts":[[2019,6,18]],"date-time":"2019-06-18T09:45:55Z","timestamp":1560851155000},"page":"1197-1203","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Routine chest CT for staging of gastric cancer"],"prefix":"10.1093","volume":"106","author":[{"given":"A-H","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W-H","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y-H","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J-H","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T-S","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C-T","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J-S","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Haematology\u2013Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7829-1504","authenticated-orcid":false,"given":"C-M","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine , Taoyuan, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"2022100812420878800_bjs11186-bib-0001","doi-asserted-by":"crossref","first-page":"93","DOI":"10.3322\/caac.21388","article-title":"The Eighth Edition AJCC Cancer Staging Manual: continuing to build a bridge from a population-based to a more \u2018personalized\u2019 approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"2022100812420878800_bjs11186-bib-0002","volume-title":"American Joint Committee on Cancer Staging Manual","author":"Edge","year":"2010","edition":"7th"},{"key":"2022100812420878800_bjs11186-bib-0003","doi-asserted-by":"crossref","first-page":"v38","DOI":"10.1093\/annonc\/mdw350","article-title":"Gastric cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"27","author":"Smyth","year":"2016","journal-title":"Ann Oncol"},{"key":"2022100812420878800_bjs11186-bib-0004","doi-asserted-by":"crossref","first-page":"2941","DOI":"10.1016\/j.ejca.2012.07.029","article-title":"First St. Gallen EORTC Gastrointestinal Cancer Conference 2012 Expert Panel. Highlights of the EORTC St. Gallen International Expert Consensus on the primary therapy of gastric, gastroesophageal and oesophageal cancer \u2013 differential treatment strategies for subtypes of early gastroesophageal cancer","volume":"48","author":"Lutz","year":"2012","journal-title":"Eur J Cancer"},{"key":"2022100812420878800_bjs11186-bib-0005","doi-asserted-by":"crossref","first-page":"1286","DOI":"10.6004\/jnccn.2016.0137","article-title":"Gastric cancer, Version 3.2016, NCCN clinical practice guidelines in oncology","volume":"14","author":"Ajani","year":"2016","journal-title":"J Natl Compr Canc Netw"},{"key":"2022100812420878800_bjs11186-bib-0006","doi-asserted-by":"crossref","first-page":"W1","DOI":"10.1097\/RTI.0b013e3182010bf9","article-title":"Expert Panel on Thoracic Imaging. ACR Appropriateness Criteria\u00ae screening for pulmonary metastases","volume":"26","author":"Mohammed","year":"2011","journal-title":"J Thorac Imaging"},{"key":"2022100812420878800_bjs11186-bib-0007","doi-asserted-by":"crossref","first-page":"52 307","DOI":"10.18632\/oncotarget.10740","article-title":"Metastatic spread in patients with gastric cancer","volume":"7","author":"Riihim\u00e4ki","year":"2016","journal-title":"Oncotarget"},{"key":"2022100812420878800_bjs11186-bib-0008","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1007\/s10120-011-0104-7","article-title":"Lung metastases in metastatic gastric cancer: pattern of lung metastases and clinical outcome","volume":"15","author":"Kong","year":"2012","journal-title":"Gastric Cancer"},{"key":"2022100812420878800_bjs11186-bib-0009","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1177\/1457496915571400","article-title":"Computed tomography of the thorax for gastric cancer staging: is it necessary?","volume":"104","author":"Chong","year":"2015","journal-title":"Scand J Surg"},{"key":"2022100812420878800_bjs11186-bib-0010","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1002\/jso.21651","article-title":"Preoperative chest computerized tomography in patients with locally advanced mid or lower rectal cancer: its role in staging and impact on treatment strategy","volume":"102","author":"Choi","year":"2010","journal-title":"J Surg Oncol"},{"key":"2022100812420878800_bjs11186-bib-0011","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1016\/j.crad.2011.10.005","article-title":"CT staging of colorectal cancer: what do you find in the chest?","volume":"67","author":"McQueen","year":"2012","journal-title":"Clin Radiol"},{"key":"2022100812420878800_bjs11186-bib-0012","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1097\/rct.0b013e318032e8c9","article-title":"Rectal cancer: incidence of pulmonary metastases on thoracic CT and correlation with T staging","volume":"31","author":"Kirke","year":"2007","journal-title":"J Comput Assist Tomogr"},{"key":"2022100812420878800_bjs11186-bib-0013","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1245\/s10434-010-0962-y","article-title":"Preoperative staging with chest CT in patients with colorectal carcinoma: not as a routine procedure","volume":"17","author":"Grossmann","year":"2010","journal-title":"Ann Surg Oncol"},{"key":"2022100812420878800_bjs11186-bib-0014","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1245\/s10434-012-2726-3","article-title":"Risk factors for survival after lung metastasectomy in colorectal cancer patients: a systematic review and meta-analysis","volume":"20","author":"Gonzalez","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"2022100812420878800_bjs11186-bib-0015","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.lungcan.2011.07.010","article-title":"Prediction of the prognosis and surgical indications for pulmonary metastectomy from colorectal carcinoma in patients with combined hepatic metastases","volume":"75","author":"Kawano","year":"2012","journal-title":"Lung Cancer"},{"key":"2022100812420878800_bjs11186-bib-0016","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1007\/s12032-015-0718-4","article-title":"Pulmonary metastases from gastric cancer: is there any indication for lung metastasectomy? A systematic review","volume":"33","author":"Aurello","year":"2016","journal-title":"Med Oncol"},{"key":"2022100812420878800_bjs11186-bib-0017","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1136\/thoraxjnl-2013-204528","article-title":"Pulmonary metastasectomy: what is the practice and where is the evidence for effectiveness?","volume":"69","author":"Treasure","year":"2014","journal-title":"Thorax"},{"key":"2022100812420878800_bjs11186-bib-0018","doi-asserted-by":"crossref","DOI":"10.1007\/978-1-4757-3656-4","volume-title":"American Joint Committee on Cancer Staging Manual","author":"Greene","year":"2002","edition":"6th"},{"key":"2022100812420878800_bjs11186-bib-0019","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/apm.1965.64.1.31","article-title":"The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. An attempt at a histo-clinical classification","volume":"64","author":"Laur\u00e9n","year":"1965","journal-title":"Acta Pathol Microbiol Scand"},{"key":"2022100812420878800_bjs11186-bib-0020","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1002\/jso.2930360405","article-title":"Pathological characteristics of gastric cancer that develop hematogenous recurrence, with special reference to the site of recurrence","volume":"36","author":"Koga","year":"1987","journal-title":"J Surg Oncol"},{"key":"2022100812420878800_bjs11186-bib-0021","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/(SICI)1096-9098(199811)69:3<147::AID-JSO5>3.0.CO;2-H","article-title":"Surgical resection of pulmonary metastases from gastric cancer","volume":"69","author":"Kanemitsu","year":"1998","journal-title":"J Surg Oncol"},{"key":"2022100812420878800_bjs11186-bib-0022","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1007\/s00268-010-0935-0","article-title":"Cancer of the gastric cardia is rising in incidence in an Asian population and is associated with adverse outcome","volume":"35","author":"Deans","year":"2011","journal-title":"World J Surg"},{"key":"2022100812420878800_bjs11186-bib-0023","doi-asserted-by":"crossref","first-page":"2679","DOI":"10.1245\/s10434-017-5838-y","article-title":"Patterns of initial recurrence in gastric adenocarcinoma in the era of preoperative therapy","volume":"24","author":"Ikoma","year":"2017","journal-title":"Ann Surg Oncol"},{"key":"2022100812420878800_bjs11186-bib-0024","doi-asserted-by":"crossref","first-page":"e84","DOI":"10.1016\/j.ejrad.2009.04.019","article-title":"Incidental lung nodules on CT examinations of the abdomen: prevalence and reporting rates in the PACS era","volume":"74","author":"Rinaldi","year":"2010","journal-title":"Eur J Radiol"},{"key":"2022100812420878800_bjs11186-bib-0025","doi-asserted-by":"crossref","first-page":"881","DOI":"10.2214\/AJR.09.3462","article-title":"Estimating effective dose for CT using dose\u2013length product compared with using organ doses: consequences of adopting International Commission on Radiological Protection publication 103 or dual-energy scanning","volume":"194","author":"Christner","year":"2010","journal-title":"AJR Am J Roentgenol"},{"key":"2022100812420878800_bjs11186-bib-0026","author":"American Association of Physicists in Medicine","year":"2018","journal-title":"Position Statement on Radiation Risks from Medical Imaging Procedures"},{"key":"2022100812420878800_bjs11186-bib-0027","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1111\/1754-9485.12492","article-title":"Development of a local relative value unit to measure radiologists' computed tomography reporting workload","volume":"60","author":"Dora","year":"2016","journal-title":"J Med Imaging Radiat Oncol"},{"key":"2022100812420878800_bjs11186-bib-0028","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.ejrad.2015.11.012","article-title":"Double reading of current chest CT examinations: clinical importance of changes to radiology reports","volume":"85","author":"Lauritzen","year":"2016","journal-title":"Eur J Radiol"},{"key":"2022100812420878800_bjs11186-bib-0029","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1136\/bmjqs-2015-004536","article-title":"Radiologist-initiated double reading of abdominal CT: retrospective analysis of the clinical importance of changes to radiology reports","volume":"25","author":"Lauritzen","year":"2016","journal-title":"BMJ Qual Saf"},{"key":"2022100812420878800_bjs11186-bib-0030","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1136\/pgmj.2004.029330","article-title":"Epidemiology of gastric cancer in Japan","volume":"81","author":"Inoue","year":"2005","journal-title":"Postgrad Med J"},{"key":"2022100812420878800_bjs11186-bib-0031","doi-asserted-by":"crossref","first-page":"e535","DOI":"10.1016\/S1470-2045(13)70436-4","article-title":"Management of gastric cancer in Asia: resource-stratified guidelines","volume":"14","author":"Shen","year":"2013","journal-title":"Lancet Oncol"},{"key":"2022100812420878800_bjs11186-bib-0032","doi-asserted-by":"crossref","first-page":"87","DOI":"10.15403\/jgld.2014.1121.251.rv2","article-title":"Recent strategies for treating stage IV gastric cancer: roles of palliative gastrectomy, chemotherapy, and radiotherapy","volume":"25","author":"Izuishi","year":"2016","journal-title":"J Gastrointestin Liver Dis"}],"container-title":["British Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.11186","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/bjs.11186","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/bjs.11186","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/106\/9\/1197\/46375919\/bjs11186.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/106\/9\/1197\/46375919\/bjs11186.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T12:59:28Z","timestamp":1665233968000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/106\/9\/1197\/6093180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,18]]},"references-count":32,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,6,18]]},"published-print":{"date-parts":[[2019,7,15]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.11186","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"value":"0007-1323","type":"print"},{"value":"1365-2168","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,8]]},"published":{"date-parts":[[2019,6,18]]},"assertion":[{"value":"2018-11-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-06-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}