To evaluate the clinical value of preoperative abdominal enhanced-contrast spiral CT for advanced gastric cancer in TNM staging, excision range and surgery choices.

One hundred and fifty cases of advanced gastric cancer diagnosed by pathology between March 2014 and May 2015 were given enhanced-contrast spiral CT to find out the accuracy of determining TNM staging, excision range and surgical methods according to surgical and pathological findings.

The accuracy of enhanced-contrast spiral CT for staging advanced gastric cancer was relatively high, 84.0% (126/150) for T2, 76.7% (115/150) for T3, 92.7% (139/150) for T4; lymph node in hilus liens, splenic artery and paraaortic was 96.3%, 97.0%, 94.8%, respectively; the accuracy and sensitivity for predicting distant metastases was 87.3% (131/150) and 93.3% (126/135). When excision range and surgery choices were taken into consideration, the accuracy of enhanced-contrast spiral CT for proximal subtotal gastrectomy, distal subtotal gastrectomy and total gastrectomy was 87.9% (29/33), 88.6% (62/70), and 72.7% (32/44); for laparoscope assisted- and open surgery was 87.7% (100/114) and 85.7% (30/35), respectively.

Enhanced-contrast spiral CT is useful for TNM staging of gastric cancer and predicting excision range and surgical methods.