Usefulness of Diagnostic Staging Laparoscopy for Advanced Gastric Cancer
Usefulness of Diagnostic Staging Laparoscopy for Advanced Gastric Cancer
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DOI：
10.1177/00031348211038554
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发表时间：
2021-08-12
期刊：
影响因子：
1
通讯作者：
Yoshimoto, Toshiaki
中科院分区：
文献类型：
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作者：
Yoshikawa, Kozo;Shimada, Mitsuo;Yoshimoto, Toshiaki
背景对于晚期胃癌（AGC），腹膜转移是最常见的无法切除的决定因素，但腹膜转移的准确术前诊断是具有挑战性的。分期腹腔镜（SL）可以发现未预料到的腹膜转移。本研究回顾性评估了SL在AGC患者中的应用及其适应症。结果114例经病理诊断的胃腺癌患者中，43例（37.7%）发生腹膜转移（P1或CY1）。年龄越大、肿瘤大小越大、4型胃癌、肿瘤深度越深、CA125升高、术前CT腹水发现是腹膜转移的重要预测因素。在多因素分析中，腹膜转移与4型GC（比值比[OR]: 6.11； 95%可信区间[CI]: 1.87-19.8; P < 0.01）和CT腹水（比值比：4.25;95% CI: 1.48-12.1; P < 0.01）相关。结论分期腹腔镜检查是检测AGC腹膜转移的有效工具。可提高治愈率，减少不必要的剖腹手术。
Background For advanced gastric cancer (AGC), peritoneal metastasis is the most common determinant of unresectability, but accurate preoperative diagnosis for peritoneal metastasis is challenging. Staging laparoscopy (SL) can detect unsuspected peritoneal metastasis. This study retrospectively evaluated the utility of SL and its indication in patients with AGC. Methods In this study, we enrolled 114 patients with pathologically diagnosed gastric adenocarcinoma who underwent SL. Results Of the 114 patients, 43 (37.7%) had peritoneal metastasis (P1 or CY1). Higher age, larger tumor size, type 4 GC, deeper tumor depth, elevated CA125, and ascites findings in preoperative CT were found to be significant predictors of peritoneal metastasis. In multivariate analysis, peritoneal metastasis was associated with type 4 GC (odds ratio [OR]: 6.11; 95% confidence interval [CI]: 1.87-19.8; P < .01) and ascites in CT (OR: 4.25; 95% CI: 1.48-12.1; P < .01). Conclusions Staging laparoscopy is an effective tool to detect peritoneal metastasis from AGC. It can increase the curative resection rate and decrease unnecessary laparotomies.