title: Predicting factors of unexpected peritoneal seeding in locally advanced gastric cancer: indications for staging laparoscopy.
abstract: OBJECTIVE
  The aim of this study is to investigate predictive factors for unexpected peritoneal seeding from clinically resectable advanced gastric cancers to suggest the indications for staging laparoscopy (SL).
  
  
  METHODS
  A total of consecutive 589 gastric cancer patients who were clinically diagnosed with advanced gastric cancer with no metastatic disease underwent operations at Seoul St. Mary's Hospital.
  
  
  RESULTS
  A total of 72 patients (including 35 patients with seeding to distant peritoneum) were surgically diagnosed with peritoneal seeding. Borrmann type 3 (OR: 4.475) or type 4 (OR: 8.243) cancer, tumor invasion of T3 (OR: 2.794) or T4 (OR: 6.841) and tumor size (4  cm  ≤  tumor size  <  8  cm; OR: 3.723 and 8  cm  ≤  tumor size; OR: 6.971) were predictive factors for overall peritoneal seeding. Borrmann type 3 (OR: 3.524) or 4 (OR: 4.695) cancer, tumor invasion of T3 (OR: 4.378) or T4 (OR: 15.817), and tumors involving the anterior wall (OR: 2.762) also turned out to be predictive factors for distant peritoneal seeding.
  
  
  CONCLUSIONS
  If SL were performed by these predictive factors, this should have been performed in 42.4% of advanced gastric cancers and the detection rates for overall peritoneal seeding would have been 24.0%.
authors.affiliation: Department of Surgery, Ajou University, School of Medicine, Suwon, Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Hur
authors.forename: Han Hong
authors.initials: HH
authors.lastname: Lee
authors.forename: Hun
authors.initials: H
authors.lastname: Jung
authors.forename: Kyo Young
authors.initials: KY
authors.lastname: Song
authors.forename: Hae Myung
authors.initials: HM
authors.lastname: Jeon
authors.forename: Cho Hyun
authors.initials: CH
authors.lastname: Park
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000601:surgery; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D014057:Tomography, X-Ray Computed