Eur J Surg Oncol. 2021 Aug 08; doi: 10.1016/j.ejso.2021.08.003. Epub 2021 Aug 08.
Staging laparoscopy in patients with advanced gastric cancer: A single center cohort study.
European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
Alexander B J Borgstein, Kammy Keywani, Wietse J Eshuis, Mark I van Berge Henegouwen, Suzanne S Gisbertz
Affiliations
Affiliations
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands.
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Cancer Center Amsterdam, the Netherlands. Electronic address: [email protected].
PMID: 34384656
DOI: 10.1016/j.ejso.2021.08.003
Abstract
BACKGROUND: Most studies exploring the role of staging laparoscopy in gastric cancer are limited by low sample size and are predominantly conducted in Asian countries. This study sets out to determine the value of staging laparoscopy in patients with advanced gastric cancer in a Western population.
METHODS: All patients with gastric cancer from a tertiary referral center without definite evidence of non-curable disease after initial staging, and who underwent staging laparoscopy between 2013 and 2020, were identified from a prospectively maintained database. The proportion of patients in whom metastases or locoregional non-resectability was detected during staging laparoscopy was established. Secondary outcomes included the avoidable surgery rate (detection of non-curable disease during gastrectomy with curative intent) and diagnostic accuracy (sensitivity, specificity, accuracy, negative and positive predictive value).
RESULTS: A total of 216 patients were included. Staging laparoscopy revealed metastatic disease in 46 (21.3 %) patients and a non-resectable tumor in three (1.4 %) patients. During intended gastrectomy, non-curable disease was revealed in 13 (8.6 %) patients. Overall sensitivity, specificity and diagnostic accuracy were 76.6 %, 100 % and 92.6 %, respectively. The positive predictive value was 100 % and the negative predictive value was 90.3 %.
CONCLUSION: Staging laparoscopy is valuable in the staging process of gastric cancer with a high accuracy in detecting non-curable disease, thereby preventing futile treatment and its associated burden.
Copyright © 2021. Published by Elsevier Ltd.
Keywords: Laparoscopy; Neoplasm staging; Stomach neoplasms
Conflict of interest statement
Declaration of competing interest Van Berge Henegouwen is consultant for Mylan, Alesi Surgical, Medtronic Johnson and Johnson and received research grants from Olympus and Stryker paid to the institut
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