Selection of patients with gastric adenocarcinoma for laparoscopic staging Journal Article
| Authors: | Sarela, A. I.; Lefkowitz, R.; Brennan, M. F.; Karpeh, M. S. |
| Article Title: | Selection of patients with gastric adenocarcinoma for laparoscopic staging |
| Abstract: | Background: 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. Methods: 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. Results: 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. Conclusions: 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. © 2006 Excerpta Medica Inc. All rights reserved. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; review; patient selection; cancer staging; neoplasm staging; laparoscopy; lymphadenectomy; adenocarcinoma; tumor localization; computer assisted tomography; prevalence; risk factor; tomography, spiral computed; stomach adenocarcinoma; stomach neoplasms; lower esophagus sphincter; stomach; spiral computer assisted tomography; stomach neoplasm; minimal access surgery |
| Journal Title: | American Journal of Surgery |
| Volume: | 191 |
| Issue: | 1 |
| ISSN: | 0002-9610 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2006-01-01 |
| Start Page: | 134 |
| End Page: | 138 |
| Language: | English |
| DOI: | 10.1016/j.amjsurg.2005.10.015 |
| PUBMED: | 16399124 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 20" - "Export Date: 4 June 2012" - "CODEN: AJSUA" - "Source: Scopus" |
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