ENHANCING STOMACH CARCINOMA STAGING: A COMPREHENSIVE REVIEW OF THE ROLE OF STAGING LAPAROSCOPY AS AN ADJUNCT TO CECT ABDOMEN

ARVIND KANWAR; PARIKSHIT MALHOTRA; MANISH YADAV; ABHINAV CHAUDHARY; UK CHANDEL

doi:10.22159/ijcpr.2024v16i2.4040

Authors

ARVIND KANWAR Department of Surgery, Dr YSPGMC Nahan, Himachal Pradesh, India.
PARIKSHIT MALHOTRA Department of Surgery, SLBSGMC Nerchowk, Himachal Pradesh, India
MANISH YADAV Department of Surgery, Dr YSPGMC Nahan, Himachal Pradesh, India https://orcid.org/0000-0002-9557-8600
ABHINAV CHAUDHARY Department of Surgery, Dr RPGMC Tanda, Himachal Pradesh, India
UK CHANDEL Department of Surgery, IGMC Shimla, Himachal Pradesh, India

DOI:

https://doi.org/10.22159/ijcpr.2024v16i2.4040

Keywords:

Stomach carcinoma, Staging laparoscopy, Contrast-enhanced computed tomography, TNM staging, Occult metastasis

Abstract

Objective: Stomach carcinoma poses challenges in accurate staging and treatment planning. This study explores the evolving role of staging laparoscopy as an adjunct to contrast-enhanced computed tomography (CECT) in enhancing stomach carcinoma staging.

Methods: Conducted at Indira Gandhi Medical College and Hospital, Shimla, a one-year prospective study included biopsy-proven gastric carcinoma patients. Exclusion criteria involved neoadjuvant chemotherapy and proven metastasis. Investigations encompassed CECT, staging laparoscopy, and diagnostic lavage.

Results: TNM staging revealed a predominance of Stage IIA (21.9%) and IIIA (25%). Locally advanced cases demonstrated infiltration into other organs (53.1%). Occult metastasis was present in 28.2%, with 66.7% in ascites cases. Staging laparoscopy detected occult metastasis in 28.2%, complementing CECT limitations. Significant associations were noted between occult metastasis and CECT staging, particularly in Stage III (88.9%).

Conclusion: Integration of staging laparoscopy with CECT enhances precision in stomach carcinoma staging. Limitations of CECT in identifying occult metastasis are addressed by staging laparoscopy, providing valuable insights. Findings underscore the importance of CECT in advanced stages, contributing to comprehensive gastric cancer management. This study contributes to evolving diagnostic and therapeutic approaches, promising improved patient outcomes.

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References

Ajani JA, D’Amico TA, Almhanna K, Bentrem DJ, Chao J, Das P. Gastric cancer. version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2016;14(10):1286-312.

Japanese Gastric Cancer Association. 5th ed. Japanese gastric cancer treatment guidelines. Gastric Cancer. 2018;24(1):1-21.

Lordick F, Mariette C, Haustermans K, Obermannova R, Arnold D, ESMO guidelines committee. Oesophageal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27Suppl 5:50-7. doi: 10.1093/annonc/mdw329, PMID 27664261.

Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355(1):11-20. doi: 10.1056/NEJMoa055531, PMID 16822992.

Washington K. 7th edition of the AJCC cancer staging manual: stomach. Annals of Surgical Oncology. 7th ed. 2010;17(12):3077-9. doi: 10.1245/s10434-010-1362-z, PMID 20882416.

Japanese Gastric Cancer Association. English edition. Gastric Cancer. Japanese classification of gastric carcinoma: 3rd. 2011;14(2):101-12.

Ychou M, Boige V, Pignon JP, Conroy T, Bouche O, Lebreton G. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol. 2011;29(13):1715-21. doi: 10.1200/JCO.2010.33.0597, PMID 21444866.

Smyth EC, Verheij M, Allum W, Cunningham D, Cervantes A, Arnold D. Gastric cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2016;27Suppl 5:v38-49. doi: 10.1093/annonc/mdw350, PMID 27664260.

Ajani JA, D’Amico TA, Almhanna K. Gastric cancer. version 3.2016, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2016;14(10):1286-312. doi: 10.6004/jnccn.2016.0137.