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 < or = 70 years (34%). On spiral CT scan, lymphadenopathy > or = 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.
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 < or = 70 years (34%). On spiral CT scan, lymphadenopathy > or = 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.
Authors: Celina Ang; Yelena Y Janjigian; Ali Shamseddine; Ayman Tawil; Maeve A Lowery; Andrew Intlekofer; Walid Faraj; Ashwaq Al-Olayan; Laura Tang; Eileen M O'Reilly; Fady Geara; Aghiad Al-Kutoubi; David P Kelsen; Ghassan K Abou-Alfa Journal: Gastrointest Cancer Res Date: 2012-03
Authors: Ibrahim Nassour; Hannah Fullington; Linda S Hynan; Adam C Yopp; Mathew M Augustine; Patricio M Polanco; Michael A Choti; John C Mansour; Sam C Wang; Matthew R Porembka Journal: Ann Surg Oncol Date: 2017-02-13 Impact factor: 5.344
Authors: Dilsa Mizrak Kaya; Graciela M Nogueras-González; Kazuto Harada; Fatemeh G Amlashi; Sinchita Roy-Chowdhuri; Jeannelyn S Estrella; Prajnan Das; Jeffrey H Lee; Brian Weston; Manoop S Bhutani; Aurelio Matamoros; Irene Thomas; Quan Lin; Brian D Badgwell; Jaffer A Ajani Journal: J Surg Oncol Date: 2017-12-04 Impact factor: 3.454