The role of staging laparoscopy in stage IV gastric cancer patients.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2025-03-07 DOI:10.1159/000543489

Leonardo Solaini, Federica Filippini, Daniele Marrelli, Marco Milone, Luigina Graziosi, Marco Realis Luc, Monica Gualtierotti, Silvia Sofia, Fausto Rosa, Maria Bencivenga, Sergio Alfieri, Giovanni Ferrari, Rossella Reddavid, Stefano De Pascale, Annibale Donini, Giovanni De Palma, Franco Roviello, Paolo Morgagni, Giorgio Ercolani

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引用次数: 0

Abstract

Introduction: Evidence regarding staging laparoscopy(SL)for clinical metastatic(cM+)gastric cancer(GC)patients is limited. Recently,Italian Gastric Cancer Research Group(GIRCG)study showed SL changed peritoneal status in over 20% of cases. This study aims to evaluate SL's role in cM+ patients and refine indications.

Methods: Data of cM+ GC patients who underwent SL between 2010 and 2022 at nine GIRCG Centers were retrospectively analyzed.Primary outcome was SL's yield,defined as peritoneal status changed by SL,over all SLs.

Results: Among 182 cM+ patients who received SL,38(20.9%)had SL-findings changing peritoneal status.10.1% of cases with preoperative signs of peritoneal carcinomatosis(PC)had no peritoneal disease,while 46.3% with extraperitoneal disease alone had PC at SL.Thirty-one patients(17.0%)underwent R0 resection:17(54.8%)with PC,3(9.7%)with liver metastases,4(12.9%)with PC and nodal metastases,2(6.4%)with lung and 1(3.2%)with bone metastases.17 patients with suspected preoperative PC underwent curative treatment:9 had peritoneal disease ruled out by SL,other 8 had limited PC,allowing R0 resection.Logistic regression revealed inverse correlation between diffuse histotype and absence of PC at SL,in patients with peritoneal involvement at imaging(p=0.02).

Conclusions: SL aids in directing cM+ GC patients to appropriate treatment,with a 20.9% yield.For those with peritoneal involvement at imaging,SL helps identify candidates for curative treatment.In patients with extraperitoneal disease,SL should be considered to assess potential radical strategies.

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.