Background: This ongoing study is a prospective evaluation of immediately preoperative video-laparoscopy compared to ultrasound/computed tomography (US/CT) staging for gastric cancer. An analysis of the first 70 cases is reported. Methods: TNM staging is used to compare the US/CT findings and the laparoscopic findings with the gold standard for pathologic findings in resected specimens. Results: In our series 47 out of 70 cases are locally advanced cancers (stages III and IV): In this subset the predictive value of laparoscopic staging is 86.4%. Laparoscopy shows an overall staging accuracy of 68.6%, compared to 32.8% for US/CT. The difference is statistically significant as regards the T factor (T3: 69.7% vs 12.1%, p < 0.002; T4: 84.2% vs 42.1%, p < 0.05); as regards the M factor, laparoscopy appears the most specific method for detecting peritoneal seeding. Conclusions: This procedure plays a crucial role in determining the resectability of the tumor, thus avoiding unnecessary laparotomies. A meticulous staging becomes mandatory when applying modem treatment options (e.g., neo-adjuvant chemotherapy) to locally advanced cancers; in this context the use of staging laparoscopy will have a relevant impact on future treatment.

D'Ugo, D. M., Coppola, R., Persiani, R., Ronconi, P., Caracciolo, F., Picciocchi, A., Immediately preoperative laparoscopic staging for gastric cancer, <<SURGICAL ENDOSCOPY>>, 1996; 10 (10): 996-999. [doi:10.1007/s004649900222] [http://hdl.handle.net/10807/170027]

Immediately preoperative laparoscopic staging for gastric cancer

D'Ugo, D. M.;Persiani, Roberto;Caracciolo, Francesca;
1996

Abstract

Background: This ongoing study is a prospective evaluation of immediately preoperative video-laparoscopy compared to ultrasound/computed tomography (US/CT) staging for gastric cancer. An analysis of the first 70 cases is reported. Methods: TNM staging is used to compare the US/CT findings and the laparoscopic findings with the gold standard for pathologic findings in resected specimens. Results: In our series 47 out of 70 cases are locally advanced cancers (stages III and IV): In this subset the predictive value of laparoscopic staging is 86.4%. Laparoscopy shows an overall staging accuracy of 68.6%, compared to 32.8% for US/CT. The difference is statistically significant as regards the T factor (T3: 69.7% vs 12.1%, p < 0.002; T4: 84.2% vs 42.1%, p < 0.05); as regards the M factor, laparoscopy appears the most specific method for detecting peritoneal seeding. Conclusions: This procedure plays a crucial role in determining the resectability of the tumor, thus avoiding unnecessary laparotomies. A meticulous staging becomes mandatory when applying modem treatment options (e.g., neo-adjuvant chemotherapy) to locally advanced cancers; in this context the use of staging laparoscopy will have a relevant impact on future treatment.
1996
Inglese
D'Ugo, D. M., Coppola, R., Persiani, R., Ronconi, P., Caracciolo, F., Picciocchi, A., Immediately preoperative laparoscopic staging for gastric cancer, <<SURGICAL ENDOSCOPY>>, 1996; 10 (10): 996-999. [doi:10.1007/s004649900222] [http://hdl.handle.net/10807/170027]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/170027
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