Staging and Surgical Approaches in Gastric Cancer: A Clinical Practice Guideline

Coburn, Natalie; Cosby, Roxanne; Klein, L.; Knight, Gregory; Malthaner, R. A.; Mamazza, Joseph; Cd, Mercer; Ringash, Jolie

doi:10.3747/co.24.3736

Cited by 41 publications

(34 citation statements)

References 56 publications

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“…The main purpose of SL is to detect occult peritoneal disease (P and/or CY) that cannot be definitively diagnosed using imaging examinations . In Western countries where advanced gastric cancer is common, a reported indication for SL was “resectable GC and EGJ without definite distant metastases”.…”

Section: Resultsmentioning

confidence: 99%

Role of staging laparoscopy for gastric cancer patients

Fukagawa

2019

Annals of Gastroent Surgery

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Staging laparoscopy (SL) is frequently carried out in patients with advanced gastric cancer. However, some clinical questions are being debated and consensus must be obtained. With this aim, a literature search of PubMed/MEDLINE was carried out using the keywords “gastric cancer,” “SL,” and “diagnostic laparoscopy”. Articles published online up to February 2019 were analyzed, focusing on the following questions. (i) What is an adequate indication for SL? (ii) How do you carry out SL? (iii) Does SL provide accurate information about peritoneal dissemination? (iv) Is the yield of SL different by tumor location? (v) Is SL a safe procedure? (vi) Is “repeat SL” needed? (vii) Does SL provide oncological benefit? Results provided the following responses: (i) In Western countries, clinically resectable advanced tumor is an indication for SL. Terms to be introduced for adequate indication include “location,” “type 4 (linitis feature),” “large tumor,” “equivocal computed tomography (CT] findings,” and “lymph node swelling”. (ii) Exploration of the entire peritoneal cavity is preferable. (iii) Detection rate of peritoneal disease is 43%‐52% in Japanese institutions and 7.8%‐40% in other countries. False‐negative findings during SL were 0%‐17%, and 10%‐13% when limited to cytology. (iv) Yield of SL was higher in gastric cancer compared with esophagogastric junctional tumor. (v) SL‐related complications were estimated to occur in 0.4%. (vi) Repeat SL is important after treatment. (vii) If the efficacy of neoadjuvant chemotherapy for patients with P0CY1 is established, SL can provide oncological benefit. SL can be carried out safely and effectively. Considering the prevalence of neoadjuvant treatment, the role of SL will become more important.

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Section: Resultsmentioning

confidence: 99%

Role of staging laparoscopy for gastric cancer patients

Fukagawa

2019

Annals of Gastroent Surgery

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“…The use of laparoscopy in gastric cancer surgery has been under investigation. There is growing evidence that laparoscopy is non-inferior to open surgery in the treatment of both early and advanced gastric cancer with regards to oncological out- [9]. The seven recommendations (MDT meetings and thoracoabdominal CT scans, D2 lymphadenectomy, at least 16 lymph nodes, R0 margin should be achieved, nonsurgical management when metastatic disease, low mortality rate should be achieved and quality metrics for lymph nodes, margin distances, perioperative mortality and oncologic outcomes should be met) presented in this paper are in harmony with the standardized practice in our institution.…”

Section: Discussionmentioning

confidence: 99%

“…The implementation of multidisciplinary team (MDT) discussions to improve preoperative staging and optimize treatment selection [7] [8], reduction in number of surgical units to increase volume per surgeon and center and the use of laparoscopic surgery are also considered important quality-enhancing factors [9]. Neoadjuvant chemotherapy and MDTmeetings were introduced in Norway in 2006 [10], and implemented at our institution in 2008.…”

Section: Introductionmentioning

confidence: 99%

Improved Survival after Implementation of Multidisciplinary Team Meetings, Perioperative Chemotherapy, Extended Lymphnode Dissection and Laparoscopic Surgery in the Treatment of Advanced Gastric Cancer

Gaupset¹,

Eftang²,

Langbach³

et al. 2018

JCT

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Aims: The treatment of gastric cancer has changed in the western countries during the last decade. This includes multidisciplinary team (MDT) meetings, perioperative chemotherapy, extended lymph node dissection, and laparoscopic surgery, all of which were gradually implemented at our department from 2008. The aim of the present study was to determine the effect of these changes on morbidity and survival. Material and Methods: 185 patients with gastric cancer were operated with curative intent from 2000 until 2016 in this retrospective, observational, follow-up study; 83 before implementation of modern principles in 2008 (period 1) and 102 were treated after 2008 (period 2). Results: The resection rate (94% vs 92.8%) and mortality rates (4.8% vs 2.9%) did not differ between the two periods. In period 2, 48 patients (47.1%), received neoadjuvant chemotherapy. In 36 patients (35.3%), laparoscopic surgery with D2 lymphadenectomy was performed. There was a significantly higher yield in the number of lymph nodes in period 2 compared to period 1 (14 vs 8, p < 0.001). This is also apparent between laparoscopic and open The five-year survival rate was significantly improved after the change in treatment principles with an estimated improvement from 30% to 40% between the periods (p = 0.033). Conclusion: The combined effect of MDT meetings, neoadjuvant chemotherapy, extended lymphnode dissection and laparoscopy has improved the prognosis of gastric cancer patients.

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“…DL should be performed before chemotherapy for patients in whom a neoadjuvant approach is considered. Washing might increase the accuracy of DL (39).…”

Section: Diagnostic Laparoscopymentioning

confidence: 99%

Significance of diagnostic laparoscopy and determination of free cancer cells in peritoneal lavage fluid in patients with gastric carcinoma

et al. 2021

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Staging and Surgical Approaches in Gastric Cancer: A Clinical Practice Guideline

Abstract: BackgroundResection is the cornerstone of cure for gastric adenocarcinoma; however, several aspects of surgical

Cited by 41 publications

References 56 publications

Role of staging laparoscopy for gastric cancer patients

Role of staging laparoscopy for gastric cancer patients

Improved Survival after Implementation of Multidisciplinary Team Meetings, Perioperative Chemotherapy, Extended Lymphnode Dissection and Laparoscopic Surgery in the Treatment of Advanced Gastric Cancer

Significance of diagnostic laparoscopy and determination of free cancer cells in peritoneal lavage fluid in patients with gastric carcinoma

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