The role of staging laparoscopy in oesophagogastric cancers

Graaf, G.W. de; Ayantunde, Abraham; Parsons, Simon L.; Duffy, John P.; Welch, Neil T.

doi:10.1016/j.ejso.2007.01.007

Cited by 92 publications

(54 citation statements)

References 29 publications

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“…Thus, staging laparoscopy has to be considered mandatory in the evaluation of GLP. It may have a role in confirming the diagnosis in doubtful cases, by demonstrating undiagnosed peritoneal seeding and by evaluating tumor resectability [13,14]. Explorative laparotomy should be avoided completely, if we consider the minimal life expectancy of these patients (median survival time 2.8 months).…”

Section: Discussionmentioning

confidence: 99%

Gastric linitis plastica: which role for surgical resection?

et al. 2011

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Background The role of surgery for gastric linitis plastica (GLP) is questioned. This study aimed to analyze our experience in the surgical treatment of GLP with specific reference to the resectability rate, prognosis, and mode of recurrence. Methods Results of surgery were analyzed in 102 patients with GLP. Results Of the 102 patients, 92 underwent surgical exploration, with resection performed in 60 cases. R2 resection was carried out in 20 patients and R1 in 12 patients, while the resection was considered potentially curative (R0) in 28 (27.5%). Overall, the median (95% confidence interval [CI]) survival time was 5.7 (3.7-7.5) months, with none of the patients alive at the end date of the study. For R0 patients the median (95% CI) survival time was 15.8 (11-20.7) months. The great majority of recurrences were intra-abdominal (peritoneal and/or locoregional), with a systemic component of the relapse that was rarely observed (5 cases). Conclusions After primary surgery, GLP showed a poor prognosis without regard to the extent or type of resection. The failure of surgical treatment related mainly to the peritoneal spread of the disease. Specifically designed multimodality treatment protocols should be tested in this setting.

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Section: Discussionmentioning

confidence: 99%

Gastric linitis plastica: which role for surgical resection?

et al. 2011

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“…MIS staging has a role in patients with potentially resectable esophageal cancer without distant metastases detected by conventional imaging. For these patients, laparoscopy can be used to identify small liver surface and peritoneal metastases while thoracoscopy can assess invasion of local structures, such as the aorta or pleura (26,28,(32)(33)(34)(35). In an interesting study, Luketich and colleagues prospectively studied the staging accuracy of PET and MIS staging in patients with potentially resectable disease.…”

Section: Benefits Of Minimally Invasive Stagingmentioning

confidence: 99%

“…The National Comprehensive Cancer Network considers laparoscopy an optional part of the staging process in patients with GEJ lesions without evidence of metastatic disease (25). Two major advantages of MIS staging are the potential avoidance of a nontherapeutic laparotomy (and its associated mortality and morbidity) due to enhanced detection of distant metastases and the identification of more patients who might benefit from neoadjuvant therapy due to improved detection of locally advanced disease (1,24,26,27).…”

Section: Minimally Invasive Surgical Stagingmentioning

confidence: 99%

Minimally invasive staging of esophageal cancer

Mehta¹,

Bianco²,

Awais³

et al. 2017

ASVIDE

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Esophageal cancer is one of the most common malignancies in the world today and the sixth-leading cause of cancer-related mortality. Accurate preoperative staging of esophageal cancer is imperative to the selection of appropriate treatments. Patients with esophageal carcinomas typically undergo a multimodality staging process including noninvasive imaging techniques, such as computed tomography (CT) and positron emission tomography (PET), as well as endoscopic ultrasound (EUS), which is slightly more invasive.Minimally invasive surgical staging, with laparoscopy, occasionally in combination with video-assisted thoracoscopy, is used in the staging process at select institutions and has been shown to be more accurate than noninvasive staging modalities. Two major advantages of minimally invasive surgical staging over conventional techniques are the improved assessment of locoregional disease and enhanced identification of distant metastases. These advantages decrease the likelihood that the patient will undergo a nontherapeutic laparotomy. Currently, no clear consensus exists regarding which patients with esophageal cancer would benefit most from the addition of minimally invasive surgical staging. We have, however, found that minimally invasive surgical staging with laparoscopy is particularly valuable in detection of occult distant metastases. In this article, we summarize the staging modalities for esophageal cancer including minimally invasive surgical staging.

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“…13(16%) of these patients were detected to have loco regionally advance disease on diagnostics copies (thoracoscopy-8, laparoscopy-5) and hence were not operated. 6 MIES was attempted on the remaining 68 patients. 64 (94%)patients successfully underwent one of the two MIES procedures.…”

Section: Patients Selected (81)mentioning

confidence: 99%