LaparoscopySelection of patients with gastric adenocarcinoma for laparoscopic staging
Section snippets
Patients and Methods
Patients who had undergone laparoscopic staging of gastric adenocarcinoma between April 1993 and May 2002, at Memorial Sloan Kettering Cancer Center (MSKCC) were identified from a prospectively maintained database. Patients who had laparoscopy between 1993 and 1995 have been included in a previous report [1]. During this period, CT scanning of the abdomen and pelvis was routinely employed for staging. An incremental technique of CT scanning was used in the early part of the study and a spiral
Results
Between April 1993 and June 2002, 1748 patients with gastric adenocarcinoma were admitted to MSKCC and 718 (41%) patients underwent a staging laparoscopy. Of these, 657 patients were eligible for inclusion in this study. There were 371 (56%) men and 286 (44%) women, median age 65 years (range 26 to 92). The primary tumor was located at the gastroesophageal junction (GEJ; 105, 16%), proximal stomach (134, 21%), gastric body (178, 27%), antrum (187, 28%) or whole stomach (carcinoma that involved
Comments
Our group has previously recommended laparoscopic staging for patients who are candidates for potentially curative resection of gastric adenocarcinoma and do not have clinically significant obstruction or bleeding [1]. Using such selection criteria, 657 patients underwent staging laparoscopy at MSKCC over a 10-year period and were eligible for inclusion in this study. M1 disease was detected at laparoscopy in 23% of patients. Another 9% of patients had a “false-negative” result by laparoscopy
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