Role of repeat staging laparoscopy in locoregionally advanced gastric or gastroesophageal cancer after neoadjuvant therapy Journal Article
| Authors: | Cardona, K.; Zhou, Q.; Gonen, M.; Shah, M. A.; Strong, V. E.; Brennan, M. F.; Coit, D. G. |
| Article Title: | Role of repeat staging laparoscopy in locoregionally advanced gastric or gastroesophageal cancer after neoadjuvant therapy |
| Abstract: | Introduction: Staging laparoscopy (SL) can identify occult, subradiographic metastatic (M1) disease in patients with gastric or gastroesophageal (G/GEJ) cancer who are unlikely to benefit from gastrectomy. The purpose of this study is to determine the yield of repeat SL following neoadjuvant therapy for G/GEJ adenocarcinoma after initial negative pretreatment SL. Methods: Retrospective review of a prospective database identified patients with locoregionally advanced (T3-4Nany or TanyN+) G/GEJ adenocarcinoma who underwent pretreatment SL. The yield of repeat SL following neoadjuvant therapy was determined. Results: From 1994 to 2010, 276 patients with locoregionally advanced G/GEJ adenocarcinoma were identified, of whom 244 proceeded to operation after neoadjuvant therapy, at a median time of 105 days. One hundred sixty-four patients (67 %) underwent repeat SL, and 80 patients (33 %) proceeded directly to laparotomy. Occult M1 disease was identified in 12 (7.3 %) and 6 (7.5 %) patients, respectively. In the repeat SL cohort, M1 disease was identified at laparoscopy in nine patients (5.5 %). M1 disease not identified by laparoscopy was discovered at laparotomy in three patients (1.8 %). The median follow-up for the study population was 31 months. For patients with M1 disease, median overall survival was 15 months, versus 41 months for patients resected without M1 disease (p < 0.0001). Conclusions: Occult, subradiographic M1 disease develops in approximately 7 % of patients following neoadjuvant therapy for locoregionally advanced G/GEJ adenocarcinoma. These patients have poor prognosis, and repeat SL can be a valuable tool in selecting patients with locoregionally advanced G/GEJ tumors for potentially curative resection after neoadjuvant therapy. © 2012 Society of Surgical Oncology. |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 20 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2013-02-01 |
| Start Page: | 548 |
| End Page: | 554 |
| Language: | English |
| DOI: | 10.1245/s10434-012-2598-6 |
| PROVIDER: | scopus |
| PUBMED: | 22941159 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 July 2013" - "CODEN: ASONF" - "Source: Scopus" |
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