Clinical significance of diagnostic laparoscopy on precision staging in advanced gastric cancer

Abstract

Gastric cancer is the leading cause of cancer-related deaths in human. More than 70% patients present with advanced gastric cancer or with metastasis in clinic. There are three “higher ratio” of phenomenons at present includ-ing higher ratio of advanced gastric cancer, higher ratio of unnecessary laparotomy, and higher ratio of non-R0 radical gastrectomy. Diagnostic laparoscopy can be used: ① to discover occult and micro enough metastatic lesions in the abdo-minal cavity which could not be diagnosed by current imaging examinations; ② to determine whether gastric cancer invaded adjacent organs; ③ to identify intraperitoneal free cancer cells using peritoneal lavage. Then the precision staging would be gotten for reasonable treatment strategy. T4b stage is diagnosed for positive preoperative treatment. Intraperitoneal occult metastatic lesions are found to avoid unnecessary gastrectomy. Separate cancer cells are screened for conversion therapy. The prognosis of patients with gastric cancer could be improved further when the neoadjuvant therapy is selected.

Keywords

• |gastric cancer|laparoscopic exploration|abdominal metastasis|clinical staging