Usefulness of staging laparoscopy for advanced gastric cancer

Shimizu, Hiroki; Imamura, Hiroshi; Ohta, Katsuya; Miyazaki, Yasuhiro; Kishimoto, Tomono; Fukunaga, Masao; Ohzato, Hiroki; Tatsuta, Masayuki; Furukawa, Hiroshi

doi:10.1007/s00595-009-4017-6

Cited by 23 publications

(26 citation statements)

References 16 publications

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“…However, studies from Western groups also report potential demerits of the procedure such as trocar injury, port site metastasis, and immunologic compromise [3][4][5][6][7]9]. The reported incidence of peritoneal metastasis in patients with type 4 and large type 3 gastric cancer is high (19.1-22.2 %) [8,14], and thus such patients are considered suitable candidates for SL, although only a few studies have investigated the value of this approach [8,11,13]. The present study therefore sought to clarify the effectiveness and limitation of SL for patients with type 4 and large type 3 gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Staging Laparoscopy for Patients with cM0, Type 4, and Large Type 3 Gastric Cancer

et al. 2015

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Section: Introductionmentioning

confidence: 99%

Staging Laparoscopy for Patients with cM0, Type 4, and Large Type 3 Gastric Cancer

et al. 2015

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“…6–24 Positive staging laparoscopy (SL) prevents unnecessary invasive operations that are associated with greater in-hospital mortality and prolonged length of stay. 9,25 Multiple reports demonstrate a uniformly poor prognosis in gastric cancer patients with peritoneal disease, leading the National Comprehensive Cancer Network (NCCN) to recommend pretreatment SL for patients with clinical stage IB or higher disease.…”

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confidence: 99%

The Yield of Staging Laparoscopy in Gastric Cancer is Affected by Racial and Ethnic Differences in Disease Presentation

et al. 2017

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Background Gastric cancer is a heterogeneous disease with variable presentation between racial and ethnic groups. Staging laparoscopy (SL) detects occult metastases not visible on cross-sectional imaging and therefore improves staging. It remains unclear how differences in race and ethnicity affect disease presentation and the yield of SL. Methods We performed a retrospective review of a prospectively maintained database to identify patients with gastric cancer treated with curative intent at our institutions from 2008 to 2015. Results Hispanic patients presented at an earlier mean age (55.5 ± 11.9 years) compared with Asian (59.8 ± 13.9 years), African American (61.0 ± 10.0 years), and white patients (61.7 ± 12.5 years; p = 0.046) and with more locally advanced disease (clinical stage T3/T4 or node positive; Hispanic 87%; African American 79%; white 68%, Asian 55%; p = 0.03). SL identified 42 patients (34%) with occult metastatic disease. Hispanics were more likely to have a positive SL (44%) than white patients (21%; p = 0.04). On univariate analysis, Hispanic ethnicity, clinical T3/T4, positive nodal disease, signet ring cells, and poor differentiation were predictors of a positive SL. On multivariable analysis, clinical T3/T4, signet ring cells, and poor differentiation independently predicted radiographically occult disease. Conclusions Hispanic patients presented with more locally advanced disease and were more likely to have occult disease found on SL compared with white patients. Laparoscopy should be used routinely as part of the pretreatment staging evaluation for patients with locally advanced disease as it alters the management in a significant proportion of patients.

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“…Prior to the introduction of laparoscopic exploration, the rate of unnecessary laparotomy in our institution was high due to improper staging. Furthermore, with the current approach of neoadjuvant treatment for advanced stage diseases, the introduction of laparoscopy would lead to a quicker referral of patients to oncology treatment (Yano et al, 2000;Shimizu et al 2010;Cardona et al, 2013). Although laparoscopy in patients with gastric cancer has been practiced for many years, the overall number of patients in each reported series is small (Mahadevan et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Three-Port Laparoscopic Exploration is not Sufficient for Patients with T4 Gastric Cancer

Huang

Jin

Long

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Gastric cancer continues to be a leading cause of cancer death. The majority of patients with gastric adenocarcinoma in China present with advanced disease. Ruling out unresectable cancers from an unnecessary ''open'' exploration is very important. The aim of this study was to assess the value of five-port anatomical laparoscopic exploration in T4 gastric cancer in comparison with three-port laparoscopic exploration and laparotomy exploration. We conducted a retrospective study on 126 patients with T4 stage scheduled for D2 curative gastrectomy based on computed tomography (CT) staging at Department of Gastric Cancer and Soft Tissue Sarcoma, Fudan University Shanghai Cancer Center, from Apr. 2011 to Apr. 2013. Laparotomy exploration (Group I), three-port laparoscopic exploration (Group II) or five-port anatomical laparoscopic exploration (Group III) were performed prior to radical gastrectomy. Accuracy rate for feasibility of D2 curative gastrectomy in laparotomy exploration and five-port anatomical laparoscopic exploration groups was higher than that in the three-port laparoscopic exploration group. Five-port anatomical laparoscopic exploration group had the highest accuracy resection rate (Group I vs Group II vs Group III,92.6% vs78.6% vs 97.7%; p<0.05) and shorter length of hospitalization (Group I vs Group II vs Group III, 9.58±4.17 vs 6.13±2.85 vs 5.00±1.81; p<0.001). Three-port laparoscopic exploration has low accuracy rate for assessing feasibility of D2 curative gastrectomy and five-port anatomical laparoscopic exploration should be performed on patients with T4 gastric cancer.

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Usefulness of staging laparoscopy for advanced gastric cancer

Abstract: Staging laparoscopy is useful for planning the treatment strategy and estimating the prognosis of patients with advanced gastric cancer.

Cited by 23 publications

References 16 publications

Staging Laparoscopy for Patients with cM0, Type 4, and Large Type 3 Gastric Cancer

Staging Laparoscopy for Patients with cM0, Type 4, and Large Type 3 Gastric Cancer

The Yield of Staging Laparoscopy in Gastric Cancer is Affected by Racial and Ethnic Differences in Disease Presentation

Three-Port Laparoscopic Exploration is not Sufficient for Patients with T4 Gastric Cancer

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