Selection of patients with gastric adenocarcinoma for laparoscopic staging

To refine selection criteria for laparoscopic staging of gastric adenocarcinoma, preoperatively available clinical and radiologic factors that may predict the risk of M1 disease were investigated. During 1993–2002, laparoscopy was performed if patients had minimal symptoms and there was no definite...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of surgery 2006, Vol.191 (1), p.134-138
Main Authors: Sarela, Abeezar I., Lefkowitz, Robert, Brennan, Murray F., Karpeh, Martin S.
Format: Article
Language:English
Subjects:
Abdomen
Adenocarcinoma - diagnostic imaging
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cancer
Cancer therapies
Digestive system. Abdomen
Endoscopy
Female
Gastric cancer
General aspects
Humans
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy
Male
Medical imaging
Medical sciences
Middle Aged
Minimal access surgery
Multivariate analysis
Neoplasm Staging
Patient Selection
Patients
Radiology
Stomach neoplasm
Stomach Neoplasms - diagnostic imaging
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
Tomography
Tomography, Spiral Computed
Ultrasonic imaging
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To refine selection criteria for laparoscopic staging of gastric adenocarcinoma, preoperatively available clinical and radiologic factors that may predict the risk of M1 disease were investigated. During 1993–2002, laparoscopy was performed if patients had minimal symptoms and there was no definite M1 disease at computed tomography (CT) scanning. High-quality, spiral, CT scans were reviewed in detail for 65 recent patients. Laparoscopy was conducted for 657 patients and M1 was detected in 31%. M1 was significantly more prevalent with tumor location at the gastroesophageal junction (GEJ; M1 in 42%) or whole stomach (66%), poor differentiation (36%) or age ≤70 years (34%). On spiral CT scan, lymphadenopathy ≥1 cm (49%) or T3/T4 tumors (63%) were associated with significantly higher prevalence of M1. On multivariate analyses, only tumor location (GEJ or whole stomach) and lymphadenopathy were independently significant and M1 was not detected in any patient with neither risk factor. With spiral CT staging, laparoscopy may be avoided if the primary tumor is not at the GEJ or whole stomach and there is no lymphadenopathy.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2005.10.015