Abstract
Background
This study aimed to evaluate laparoscopy as a diagnostic method for detecting recurrence in patients with advanced gastric cancer.
Methods
Diagnostic laparoscopy was performed for 12 patients with insufficient evidence of intraabdominal gastric cancer recurrence by computed tomography or positron emission tomography. By comparing laparoscopic observations with conventional radiologic results, the diagnostic accuracy of laparoscopy was assessed.
Results
In 11 (92%) of 12 cases of recurrence not diagnosed by imaging studies, laparoscopic examination confirmed the case as a recurrence. Using diagnostic laparoscopy, retroperitoneal lymph node recurrence was confirmed in two patients, peritoneal seeding nodules in five patients, and recurrent masses invading the mesocolon in two patients. Two patients had no definitive recurrence grossly but were confirmed as recurrence cases by washing cytology during the laparoscopic procedure. One patient had a duodenal stump recurrence. No patients experienced operation-related morbidity.
Conclusion
Laparoscopy is a safe and feasible method for detecting recurrence with acceptable accuracy. This approach provides more accurate information than conventional imaging methods.
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References
Parkin DM, Bray F, Ferlay J, Pisani P (2005) Global cancer statistics: 2002. CA Cancer J Clin 55:74–108
Park CH, Song KY, Kim SN (2008) Treatment results for gastric cancer surgery: 12 years’ experience at a single institute in Korea. Eur J Surg Oncol 34:36–41
Song KY, Park SM, Kim SN, Park CH (2008) The role of surgery in the treatment of recurrent gastric cancer. Am J Surg 196:19–22
Maehara Y, Hasuda S, Koga T, Tokinaga E, Kakeji Y, Sugimachi K (2000) Postoperative outcome and sites of recurrence in patients following curative resection of gastric cancer. Br J Surg 87:353–357
Otsusji E, Yamaguchi T, Sawai K, Hagiwara A, Taniguchi H, Takahashi T (1998) Recent advances in surgical treatment have improved the survival of patients with gastric carcinoma. Cancer 82:1233–1237
Ichiyoshi Y, Toda T, Minamisono Y, Nagasaki S, Yakeishi Y, Sugimachi K (1990) Recurrence in early gastric cancer. Surgery 107:489–495
Kim JH, Jang YJ, Park SS, Park SH, Mok YJ (2010) Benefit of postoperative surveillance for recurrence after curative resection for gastric cancer. J Gastrointest Surg 14:969–976
Park MJ, Lee WJ, Lim HK, Park KW, Choi JY, Kim BT (2009) Detecting recurrence of gastric cancer: the value of FDG PET/CT. Abdom Imaging 34:441–447
Sarela AI, Miner TJ, Karpeh MS, Coit DG, Jaques DP, Brennan MF (2006) Clinical outcomes with laparoscopic stage M1, unresected gastric adenocarcinoma. Ann Surg 243:189–195
Song KY, Kim JJ, Kim SN, Park CH (2007) Staging laparoscopy for advanced gastric cancer: is it also useful for the group which has an aggressive surgical strategy? World J Surg 31:1228–1233
De Vita F, Orditura M, Matano E, Bianco R, Carlomagno C, Infusino S, Damiano V, Simeone E, Diadema MR, Lieto E, Castellano P, Pepe S, De Plasido S, Galizia G, Di Martino N, Ciardiello F, Catolano G, Bianco AR (2005) A phase II study of biweekly oxaliplatin plus infusional 5-fluorouracil and folinic acid (FOLFOX-4) as first-line treatment of advanced gastric cancer patients. Br J Cancer 92:1644–1649
Koizumi W, Narahara H, Hara T, Takagane A, Akiya T, Takagi M, Miyashita K, Nishizaki T, Kobayashi O, Takiyama W, Toh Y, Nagaie T, Takagi S, Yamamuta Y, Yanaoka K, Orita H, Takeuchi M (2008) S-1 plus cisplatin versus S-1 alone for first line treatment of advanced gastric cancer. (SPIRITS trial). Lancet Oncol 9:215–221
Yoo CH, Noh SH, Shin DW, Choi SH, Min JS (2000) Recurrence following curative resection for gastric cancer. Br J Surg 87:236–242
Jadvar H, Tatlidil R, Garcia AA, Conti PS (2003) Evaluation of recurrent gastric malignancy with F-18 FDG positron emission tomography. Clin Radiol 58:215–221
De Potter T, Flamen P, Van Custem E, Penninckx F, Filez L, Bormans G, Maes A, Mortelmans L (2002) Whole-body PET with FDG for the diagnosis of recurrent gastric cancer. Eur J Nucl Med 29:525–529
Yano M, Tsujinaka T, Shiozaki H, Inoue M, Sekimoto M, Doki Y, Takiguchi S, Imamura H, Taniguchi M, Monden M (2000) Appraisal of treatment strategy by staging laparoscopy for locally advanced gastric cancer. World J Surg 24:1130–1136
Littlell RD, Hallonquist H, Matulonis U, Seiden MV, Berkowitz RS, Duska LR (2006) Negative laparoscopy is highly predictive of negative second-look laparotomy following chemotherapy for ovarian, tubal, and primary peritoneal carcinoma. Gynecol Oncol 103:570–574
Husain A, Chi DS, Prasad M, Abu-Rustum N, Barakat RR, Brown CL, Poynor EA, Hoskins WJ, Curtin JP (2001) The role of laparoscopy in second-look evaluation for ovarian cancer. Gynecol Oncol 80:44–47
Acknowledgments
This study was supported by the Cancer Research Fund of the Catholic Comprehensive Cancer Institute in 2010. We give special thanks to Dr. Y. J. Lee, a radiologist from the Department of Radiology, for reviewing the preoperative CT scan and PET images.
Disclosures
Jung Ho Shim, Han Mo Yoo, Han Hong Lee, Jun Gi Kim, Hae Myung Jeon, Kyo Young Song, and Cho Hyun Park have no conflicts of interest or financial ties to disclose.
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Shim, J.H., Yoo, H.M., Lee, H.H. et al. Use of laparoscopy as an alternative to computed tomography (CT) and positron emission tomography (PET) scans for the detection of recurrence in patients with gastric cancer: a pilot study. Surg Endosc 25, 3338–3344 (2011). https://doi.org/10.1007/s00464-011-1722-1
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DOI: https://doi.org/10.1007/s00464-011-1722-1