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Vol. 65. Issue 1.
Pages 66-80 (January - February 2023)
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Vol. 65. Issue 1.
Pages 66-80 (January - February 2023)
Update in Radiology
Gastric adenocarcinoma: A review of the TNM classification system and ways of spreading
Adenocarcinoma gástrico: revisión del TNM y de las vías de diseminación
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690
P. López Sala
Corresponding author
paullopezsala@gmail.com

Corresponding author.
, M. Leturia Etxeberria, E. Inchausti Iguíñiz, A. Astiazaran Rodríguez, M.I. Aguirre Oteiza, M. Zubizarreta Etxaniz
Servicio de Radiodiagnóstico, Hospital Universitario Donostia, Donostia-San Sebastián, Spain
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Abstract

Gastric cancer is the fifth most common cancer in the world. The most common histologic subtype is adenocarcinoma. Gastric adenocarcinomas are staged using the American Joint Committee on Cancer’s 8th TNM classification. The perigastric ligaments, mesentery, omentum, and potential spaces between the parietal and visceral peritoneal linings play are important structures for staging. The spread of disease is influenced by the location of the tumor within the stomach, as well as by the anatomy related to the ligaments and lymph vessels. CT is the imaging modality of choice for the preoperative clinical staging of gastric cancer, and it is essential for planning treatment. To be able to do an adequate imaging workup, radiologists need to know the different pathways through which gastric cancer can spread: lymphatic, subperitoneal, direct invasion, transperitoneal, hematogenous, and extramural venous invasion.

Keywords:
Stomach
Stomach tumors
Adenocarcinoma
Tumor staging
Neoplastic invasion
Diagnostic imaging
Computed tomography
Resumen

El cáncer gástrico es el quinto cáncer más frecuente en el mundo. El subtipo histológico más frecuente es el adenocarcinoma. Para su estatificación se utiliza la 8.ª edición de la clasificación TNM de la American Joint Comittee on Cancer. Los ligamentos perigástricos, mesenterio, omento y espacios potenciales entre los revestimientos peritoneales parietal y visceral, son estructuras con gran implicación en la estadificación. La diseminación de la enfermedad se ve afectada por la localización del tumor en el estómago, así como por la anatomía ligamentaria y linfática. La tomografía computarizada es la modalidad de imagen de elección para la estadificación clínica preoperatoria del cáncer gástrico, y es esencial para la planificación del tratamiento. Existen múltiples vías de diseminación en el cáncer gástrico que se deben conocer para poder realizar una correcta valoración radiológica: linfática, subperitoneal, invasión directa, transperitoneal, hematógena e invasión venosa extramural.

Palabras clave:
Estómago
Neoplasias de estómago
Adenocarcinoma
Estadificación de neoplasias
Invasión neoplásica
Diagnóstico por imagen
Tomografía computarizada

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