Staging laparoscopy in gastric cancer surgery. A population-based cohort study in patients undergoing gastrectomy with curative intent
| Autor: | Mark I. van Berge Henegouwen, Alexander B. J. Borgstein, Wietse J. Eshuis, Wytze Laméris, Suzanne S. Gisbertz, Dutch Upper Gi Cancer Audit |
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| Přispěvatelé: | Surgery, VU University medical center, CCA - Cancer Treatment and quality of life, Graduate School, CCA - Cancer Treatment and Quality of Life, Amsterdam Gastroenterology Endocrinology Metabolism, Cancer Center Amsterdam |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Population Adenocarcinoma Unnecessary Procedures Contraindications Procedure 03 medical and health sciences 0302 clinical medicine Gastrectomy Predictive Value of Tests Risk Factors Stomach Neoplasms medicine Humans In patient Stage (cooking) education Laparoscopy Neoplasm Staging Retrospective Studies Curative intent education.field_of_study medicine.diagnostic_test business.industry Cancer General Medicine Middle Aged medicine.disease Surgery Diagnostic Techniques Surgical Oncology 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business Cohort study |
| Zdroj: | On behalf of the Dutch Upper GI Cancer Audit 2021, ' Staging laparoscopy in gastric cancer surgery. A population-based cohort study in patients undergoing gastrectomy with curative intent ', European Journal of Surgical Oncology, vol. 47, no. 6, pp. 1441-1448 . https://doi.org/10.1016/j.ejso.2020.11.011 European Journal of Surgical Oncology, 47(6), 1441-1448. W.B. Saunders Ltd European journal of surgical oncology, 47(6), 1441-1448. W.B. Saunders Ltd |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2020.11.011 |
| Popis: | Background: Studies on the value of a staging laparoscopy in detecting metastases in gastric cancer patients show great variation. This study investigates the avoidable surgery rate in patients with and without a staging laparoscopy scheduled for surgery with curative intent. Methods: This population-based cohort study included all patients with an intentional resection for a potentially curable gastric adenocarcinoma, between 2011 and 2016, registered in the Dutch Upper GI Cancer audit. Patients with and without a staging laparoscopy were compared. The primary outcome was the avoidable surgery rate (detection of metastases and/or locoregional non-resectable tumor during intentional gastrectomy). Secondary outcomes were the negative predictive value, postoperative morbidity and pathology parameters. Results: 2849 patients who underwent an intentional gastrectomy were included. 414 of 2849 (14.5%) patients underwent a staging laparoscopy before initiation of treatment. The avoidable surgery rate was 16.2% in the staging laparoscopy group, compared to 8.5% in the non-staging group (P < 0.001), resulting in a negative predictive value of 83.8%. The avoidable surgery rate remained significantly different after correction for possible confounders. The main reason for not executing the gastrectomy was the presence of distant metastasis in both groups. cT and cN stage were significantly higher in patients who underwent a staging laparoscopy. Conclusions: The staging laparoscopy group had a higher cTN and pTN stage, implicating selection of patients with more advanced disease for a staging laparoscopy. Despite the staging laparoscopy, a higher rate of avoidable surgery was found, suggesting a low sensitivity for detecting metastases or locoregional non-resectability in this patient group. |
| Databáze: | OpenAIRE |
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