[The role of staging laparoscopy in clinical stage III/IV gastric cancer].
We investigated the significance of staging laparoscopy (SL) for clinical Stage III/IVgastric cancer.SL was performed in 60 patients with clinical Stages III/IV gastric cancer.Pre -SL Stages were T3/4a/4b in 3/49/8 patients, N1/2/3 in 14/21/25, M0/ 1 in 38/22, and IIIA/IIIB/IIIC/IV in 16/13/9/22 patients, respectively.After SL, 11 patients were downstaged from T4a to T3, and 3 patients were downstaged from T4b to T4a.Moreover, 14 patients of P0 were identified as P1 or CY1, and 1 patient of H0 was identified as H1 after SL.As a result, post-SL Stages were IIB/IIIA/IIIB/IIIC/IV in 3/17/9/2/29 patients, respectively. In Stage III patients, staging was changed in 17 patients (44.7%) and the treatment strategies were changed in 9 patients (23.7%).In Stage IV cases, none of the patients changed staging and treatment strategies after SL.In conclusion, SL is useful for accurate staging and determining the treatment strategies in Stage III gastric cancer; however, re-evaluation is needed for the indication of SL in Stage IV gastric cancer.
Gastrointestinal Center, Yokohama City University Medical Center.
Kazuhito
K
Tsuchida
Chikara
C
Kunisaki
Takuo
T
Watanabe
Hidetaka
H
Ono
Takashi
T
Oshima
Tadao
T
Fukushima
Takaki
T
Yoshikawa
Yasushi
Y
Rino
Toshio
T
Imada
Munetaka
M
Masuda
D006801:Humans; D010535:Laparoscopy; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy