gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

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Surgical and multimodality therapy of gastric cancer with peritoneal carcinosis

Meeting Abstract

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  • corresponding author presenting/speaker Peter M. Schlag - Charité - Universitätsmedizin Berlin, Campus Buch, Klinik für Chirurgie und Chirurgische Onkologie, Deutschland

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocIS087

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dkk2006/06dkk087.shtml

Published: March 20, 2006

© 2006 Schlag.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Gastric cancer frequently spreads to the peritoneal cavity. The general value of laparoscopy for planning therapy remains controversial. We investigated its utility compared to other diagnostic tools. We included 660 consecutive gastric cancer patients treated between 1992-2004. We compared abdominal ultrasound (US), computed tomography (CT), and staging laparoscopy (SLAP) in terms of sensitivity for detecting synchronous peritoneal carcinomatosis (PCA). The lesions were biopsied and classified as P1, P2, or P3 according to Japanese Research Society for Gastric Cancer. The patients were followed and their prognosis was determined according to the PCA stage and various therapeutic procedures. 110 of 660 patients (17%) presented with synchronous PCA. Thirty-seven PCA patients (34%) were classified as P1, 22 (20%) as P2, and 51 (46%) as P3. The sensitivity for detecting PCA by SLAP was 85% compared to 19% for US; and 28% for CT. False negative SLAP results were caused by adhesions from prior surgery or small non-visible PCA-implants. P3 patients did not benefit from additional surgery, compared to chemotherapy alone. P1 patients showed improved survival rates after complete resection followed by chemotherapy. SLAP improves PCA detection and classification and offers gastric cancer patients a more individualised and effective therapy.