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Yield of staging laparoscopy in gastric cancer is influenced by Laurén histologic subtype
Author(s) -
RawiczPruszyński Karol,
Mielko Jerzy,
Pudło Kamil,
Lisiecki Radosław,
Skoczylas Tomasz,
Murawa Dawid,
Polkowski Wojciech Piotr
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25711
Subject(s) - medicine , logistic regression , gastrectomy , laparoscopy , ascites , cytology , cancer , adenocarcinoma , gastroenterology , radiology , surgery , pathology
Background Staging laparoscopy (SL) with cytologic lavage is a useful staging procedure that allows tailoring the treatment of advanced gastric cancer (GC). The current study aimed to evaluate the total yield of SL in patients with various Laurén histo‐types of GC, before planned neoadjuvant chemotherapy and gastrectomy. Methods After exclusion of distant metastatic disease on imaging modalities, 173 patients with primary advanced gastric adenocarcinoma who underwent SL between August 2016 and September 2018, were eligible for the analysis. Patients sex, age, Lauren histo‐type, tumor location, grade, cT, and cN were assessed in bivariate analysis. Multivariable logistic regression analysis was used to identify independent factors associated with peritoneal metastases. Results Peritoneal metastases, ascites, and positive cytology were found in 39 (22.5%), 17 (9.8%) and 38 (22%) patients, respectively. The total yield of the SL in the current study was 36.4%. Multivariable logistic regression analysis revealed that serosal involvement (cT4) and diffuse histo‐type were independent predictors of peritoneal metastases (OR, 15; 95% CI, 1.9–119, P = .02 and OR, 2.4; 95% CI, 1.2–4.6, P = .01, respectively). Conclusions Although cT4 and diffuse tumors show the highest association with peritoneal metastases, SL is a valuable diagnostic procedure in all advanced GC patients.