Staging laparoscopy, along with peritoneal lavage, plays a critical role in managing locally advanced gastric cancer by identifying peritoneal metastases and free cancer cells. This comprehensive study, conducted at a high-volume center in Sweden, involved 168 patients and spanned from February 2008 to October 2022. It classified patients based on laparoscopy findings: 46% PC-CY- (negative for peritoneal carcinomatosis and cytology), 17% PC-CY+ (positive cytology without visible carcinomatosis), and 36% PC+ (visible peritoneal carcinomatosis).
Key Findings:
Patients with PC-CY+ or PC+ had significantly decreased overall survival (OS) compared to PC-CY- patients.
PC-CY+ patients who converted to PC-CY- after chemotherapy and subsequently underwent tumor resection had improved survival outcomes.
However, the prognosis for PC+ patients remained poor even after treatment.
Clinical Implications:
The findings highlight the importance of staging laparoscopy in the staging and management of gastric cancer. It suggests that tumor resection should be considered for PC-CY+ patients who convert to PC-CY- following chemotherapy, as this approach can lead to better survival outcomes. This study supports the continued use and potential expansion of staging laparoscopy in treatment planning for gastric cancer patients.
Conclusion:
Staging laparoscopy is essential for accurate staging and treatment planning in locally advanced gastric cancer. For PC-CY+ patients, chemotherapy followed by tumor resection could offer a survival benefit. These insights should be integrated into clinical practice to improve patient outcomes.
Reference:
https://doi.org/10.1016/j.ejso.2024.108059
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