Indian Journal of Cancer
Home  ICS  Feedback Subscribe Top cited articles Login 
Users Online :3106
Small font sizeDefault font sizeIncrease font size
Navigate Here
 »   Next article
 »   Previous article
 »   Table of Contents

Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded373    
    Comments [Add]    
    Cited by others 2    

Recommend this journal


Year : 2014  |  Volume : 51  |  Issue : 1  |  Page : 15-17

Staging laparoscopy in gastroesophageal and gastric adenocarcinoma: First experience from Pakistan

1 Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
2 Department of Surgery, Civil Hospital, Karachi, Pakistan

Correspondence Address:
A B Bhatti
Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-509X.134603

Rights and Permissions

Context: Current NCCN guidelines do not consider staging laparoscopy mandatory for detection of metastasis in gastroesophageal junction (GEJ) and gastric cancer. Aims: To determine the rate of detection of metastasis on staging laparoscopy in GEJ and gastric cancer in Pakistani population and determine the prognostic significance of cytology versus biopsy positive metastatic disease. Settings and Design: Retrospective study conducted from January 2005 to June 2013. Materials and Methods: Demographics, clinicopathological characteristics and laparoscopic findings of 149 patients were compared. Statistical Analysis Used: Categorical variables were represented as frequencies and percentages and significance was determined using Chi square test. Overall survival was calculated from the date of staging laparoscopy to the date of death/last follow-up. Survival for cytology versus biopsy positive metastatic disease was calculated using Kaplan Meier curves and significance determined with Log rank test. Results: Overall, metastases were detected in 40% of patients on staging. Laparoscopy detected metastasis in significantly high number of gastric cancers (48% versus 28%) (P = 0.01). Peritoneal nodules were more frequent with gastric tumors (40% versus 23%) and also were more likely to be malignant (58% versus 35%). Expected one year survival in patients with positive cytology (peritoneal washing/ascitic fluid) was significantly higher than patients with a positive peritoneal nodule biopsy (29% versus 0) (P = 0.04). On univariate analysis this was the only significant factor for increased risk of death (P = 0.03, HR = 2.5, CI = 1.04-5.98). Conclusions: Staging laparoscopy detects metastatic disease in a significant number of patients deemed non metastatic on preoperative imaging. Prognostically, cytology positive metastatic cancer may be different from biopsy positive cancer.


Print this article     Email this article

  Site Map | What's new | Copyright and Disclaimer
  Online since 1st April '07
  © 2007 - Indian Journal of Cancer | Published by Wolters Kluwer - Medknow