BACKGROUND: A better method for detecting early peritoneal progression is needed. This study evaluated the feasibility and accuracy of second-look laparoscopy for patients with gastric cancer treated using systemic chemotherapy after gastrectomy. METHODS: Second-look laparoscopy was conducted for patients who had no clinical evidence of distant metastases but had peritoneal metastases or positive peritoneal cytology results without visible metastatic disease at initial surgery, patients who underwent systemic chemotherapy over a 6-month period after surgery, and patients who had no clinical evidence of disease based on imaging study after completion of primary chemotherapy. RESULTS: Between November 2004 and April 2008, 21 patients underwent second-look laparoscopy. At the initial surgery, 13 of these patients underwent total gastrectomy and 8 patients underwent distal gastrectomy. One or two sheets of adhesion barrier were received by 18 patients. The median interval between initial surgery and second-look laparoscopy was 9.8 months (range, 6.6-17.5 months). All second-look procedures were completed laparoscopically, and no patients required conversion to laparotomy. None of the 21 patients experienced postlaparoscopy complications. Whereas 12 patients showed no pathologic evidence of disease, 9 patients showed disease at second-look laparoscopy. There was a significant difference in median survival between the groups with negative and positive results (p = 0.017). The median survival for the negative group has not been determined. All the patients in the positive group received further chemotherapy while showing a good performance status (PS). Six patients were PS 0, and 3 patients were PS 1. The median survival time for this group was 10.1 months. CONCLUSIONS: Second-look laparoscopy was a safe and promising approach to reassessment of peritoneal disease for patients with gastric cancer. The incidence of complications was low, particularly in this group of patients, all of whom had undergone prior gastrectomy.
BACKGROUND: A better method for detecting early peritoneal progression is needed. This study evaluated the feasibility and accuracy of second-look laparoscopy for patients with gastric cancer treated using systemic chemotherapy after gastrectomy. METHODS: Second-look laparoscopy was conducted for patients who had no clinical evidence of distant metastases but had peritoneal metastases or positive peritoneal cytology results without visible metastatic disease at initial surgery, patients who underwent systemic chemotherapy over a 6-month period after surgery, and patients who had no clinical evidence of disease based on imaging study after completion of primary chemotherapy. RESULTS: Between November 2004 and April 2008, 21 patients underwent second-look laparoscopy. At the initial surgery, 13 of these patients underwent total gastrectomy and 8 patients underwent distal gastrectomy. One or two sheets of adhesion barrier were received by 18 patients. The median interval between initial surgery and second-look laparoscopy was 9.8 months (range, 6.6-17.5 months). All second-look procedures were completed laparoscopically, and no patients required conversion to laparotomy. None of the 21 patients experienced postlaparoscopy complications. Whereas 12 patients showed no pathologic evidence of disease, 9 patients showed disease at second-look laparoscopy. There was a significant difference in median survival between the groups with negative and positive results (p = 0.017). The median survival for the negative group has not been determined. All the patients in the positive group received further chemotherapy while showing a good performance status (PS). Six patients were PS 0, and 3 patients were PS 1. The median survival time for this group was 10.1 months. CONCLUSIONS: Second-look laparoscopy was a safe and promising approach to reassessment of peritoneal disease for patients with gastric cancer. The incidence of complications was low, particularly in this group of patients, all of whom had undergone prior gastrectomy.
Authors: S H Rosenoff; R C Young; T Anderson; C Bagley; B Chabner; P S Schein; S Hubbard; V T DeVita Journal: Ann Intern Med Date: 1975-07 Impact factor: 25.391
Authors: Abeezar I Sarela; Thomas J Miner; Martin S Karpeh; Daniel G Coit; David P Jaques; Murray F Brennan Journal: Ann Surg Date: 2006-02 Impact factor: 12.969
Authors: A Gadducci; E Sartori; T Maggino; P Zola; F Landoni; A Fanucchi; N Palai; C Alessi; A M Ferrero; S Cosio; R Cristofani Journal: Gynecol Oncol Date: 1998-02 Impact factor: 5.482
Authors: J A Ajani; P F Mansfield; P M Lynch; P W Pisters; B Feig; P Dumas; D B Evans; I Raijman; K Hargraves; S Curley; D M Ota Journal: J Clin Oncol Date: 1999-08 Impact factor: 44.544
Authors: Ian Chau; Andy R Norman; David Cunningham; Justin S Waters; Jacqui Oates; Paul J Ross Journal: J Clin Oncol Date: 2004-06-15 Impact factor: 44.544
Authors: Paolo Aurello; Niccolò Petrucciani; Laura Antolino; Diego Giulitti; Francesco D'Angelo; Giovanni Ramacciato Journal: World J Gastroenterol Date: 2017-05-21 Impact factor: 5.742