Impact of Diagnostic Laparoscopy on Upstaging in GEJ Cancer
Author Information
Author(s): Alcasid Nathan J. MD, Fink Deanna MPH, Banks Kian C. MD, Susai Cynthia J. MD, Barnes Katherine BS, Wile Rachel BS, Sun Angela BS, Patel Ashish MD, Ashiku Simon MD, Velotta Jeffrey B. MD
Primary Institution: University of California, San Francisco-East Bay
Hypothesis
Routine diagnostic laparoscopy with washings yields low upstaging results in Siewert II compared with Siewert III tumors.
Conclusion
Routine diagnostic laparoscopy yields a low upstaging rate in Siewert II GEJ adenocarcinomas while delaying treatment with no improvement on mortality.
Supporting Evidence
- 5% of Siewert II patients were upstaged compared to 17% of Siewert III patients.
- Patients with diagnostic laparoscopy had longer times to chemotherapy initiation and definitive surgery.
- Routine diagnostic laparoscopy did not improve 5-year survival rates.
Takeaway
Doctors looked at patients with a certain type of stomach cancer to see if a procedure called laparoscopy helps find out how serious the cancer is. They found it doesn't help much and can actually slow down treatment.
Methodology
Patients with Siewert II/III GEJ cancer from 2012 to 2022 were reviewed, comparing those who underwent diagnostic laparoscopy with those who did not.
Potential Biases
Potential bias due to the retrospective nature and exclusion of patients receiving palliative care.
Limitations
The study was retrospective and limited to a single tertiary referral center, which may affect the generalizability of the findings.
Participant Demographics
Patients were mostly Stage III at diagnosis, with a median age of 67 years.
Statistical Information
P-Value
0.025
Confidence Interval
95% CI 35–49 days for time to chemotherapy initiation
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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